中文摘要：

目的研究小细胞肺癌（SCLC）患者不同分期外周血循环肿瘤细胞（CTC）的表达情况，探讨其在肺癌转移早期诊断中的意义。方法病例对照研究。选取2011年4月至2013年4月在上海长海医院住院治疗的SCLC患者35例（局限期12例，广泛期23例）和非结核肺良性疾病患者25例。采集静脉血7．5ml放人CellSave管中，样品经过处理后经CellTracksAutoPrep系统荧光扫描后，系统根据荧光结果判读，对CTC进行计数。分析比较SCLC和良性肺疾病患者外周血CTC表达的差异，分析比较临床广泛期和局限期SCLC患者CTC表达的差异。同时，采集2ml静脉血，离心后取上清液进行NSE（神经元特异性烯醇化酶）检测。研究CTC与NSE的相关性。相关分析采用Sperman’srank法。结果SCLC患者外周血CTC表达显著高于良性疾病对照组[CTC≥1阳性率分别为80．0％和12．0％（X^2=27．003，P〈0．0001），CTCi〉5的阳性率分别为51．4％和0（X^2=18．367，P〈0．0001），CTC≥10阳性率分别为34．3％和0（X^2=10．714，P〈0．001），CTC≥50阳性率分别为17．1％和0（P=0．036，P〈0．05）]。广泛期SCLC的CTC阳性率显著高于局限期[CTC≥1阳性率分别为58．3％和91．3％（P=0．033，P〈0．05），CTC≥5的阳性率分别为65．2％和25．0％（P=0．035，P〈0．05）]。SCLC患者外周血CTC数量与血清NSE水平呈明显正相关（r=0．7437，P〈0．0001）。结论SCLC患者CTC的表达显著高于良性对照组，且与临床分期密切相关，CTC的表达对于早期预测SCLC的转移和恶化具有一定的指导意义。（乒华检验医学杂志，2014，37：371．373）

英文摘要：

Objective To investigate the expression of Circulating tumor cells （CTCs） in peripheral blood cells of patients with different stages of Small-Cell Lung Cancer （SCLC） , and to evaluate its significance in early diagnosis of lung cancer metastasis. Methods Thirty-five patients with SCLC （ 12 in limited stage and 23 in extensive stage ） and 25 patients with benign lung disease were recruited at the Shanghai Changhai Hospital from April 2011 to April 2013. Samples were prepared from 7.5 ml peripheral venous blood and collected in CellSave tubes. The CTC counts were determined using CellTracks AutoPrep fluorescence scanning system according to the manufacturers＇ instructions. The expression of CTCs in peripheral blood of SCLC patients and benign lung disease patients were analyzed. The expression of CTCs in different stages of SCLC was measured and compared. Furthermore, samples were prepared from 2 ml peripheral venous blood by centrifugation. The serum levels of NSE Neuron specific enolase were measured. The relationship between the expression of CTC and NSE was analyzed. Results CTCs positive rates in SCLC were significantly higher than in benign lung disease controls [ Positive rates of CTC 1〉 1 were 80. 0% and12.0%（X2=27.003,P〈0.000 1） ,CTCt〉5 were 51. 4% and0 （X^2=18.367,P〈0.0001）,CTC/〉 10 were 34. 3% and 0 （ X^2 = 10. 714, P 〈 0. 001 ） , CTC 〉t50 were 17.1 and 0 （P = 0. 036,P 〈 0. 05 ） , respectively]. CTCs positive rates in SCLC extensive stage were significantly higher than limited-stage [ Positive rates of CTC≥1 were 58.3% and 91.3%（P=0.033,P〈0.05）, CTC〉15 were 65.2% and 25.0% （P = 0. 035, P 〈 0. 05 ）, respectively 1. The expression of CTCs was significantly correlated with NSE （ r = 0. 743 7, P 〈 0, 000 1 ）. Conclusion The expression of CTC in SCLC patients is significantly higher than those in control group, and is closely related to clinical stages, which may provide new clues to early predicting of SCLC metastasis and deterioration. （