胡华利， 王理， 喻风雷^*

（  中南大学湘雅二医院,410012；  ）

摘要： 循环非血液细胞在形态学上难以鉴别循环肿瘤细胞与循环内皮细胞，本文旨在探索一个鉴别循环肿瘤细胞和循环内皮细胞的新方法。采取56例进展期非小细胞肺癌患者外周血，通过ISET技术联合巴氏染色分离富集及鉴定出循环非血液细胞，对于形态学上难以区分出来的细胞，进一步采用原位免疫细胞化学检分析免疫表型，通过体外细胞实验证明该方法简单可行，未见假阳性及假阴性结果，在临床上应用得到进一步证实。因此，ISET技术巴氏染色联合原位免疫细胞化学技术，可以在肺癌以及其他实体瘤患者中检测循环非血液细胞，为循环肿瘤细胞的研究铺平道路。
关键词： 非小细胞肺癌，ISET，循环肿瘤细胞，循环非血液细胞，原位免疫细胞化学

Huali Hu， Li Wang， Fenglei Yu^*

（  Second Xiangya hospital of central south university,410012；  ）

Abstract： Circulating nonhematic cells (CNHCs) with typical malignant feature (CTCs) could be diagnosed confidently according to morphological diagnosis standards provided by former researchers,while CNHCs with uncertain malignant feature(CNHCs-UMF) could not be made clear what they were and where they came from at present.In this study, we aimed to find a way to find out what exactly these cells were.Peripheral blood samples of 56 patients with advanced NSCLC were filtered though ISET and the captured cells were stained with Pap staining. CNHCs-MF and CNHCs-UMF were screened out according to morphological diagnosis standards and were immunostained with AE1/AE3 in situ.Our results showed that all patients were observed to have CNHCs.A number of CNHCs-MF were identified in 42.8%(24/56) patients according to morphological reference standards,while CNHCs-UMF were also observed in other patients alone.Among these CNHCs-UMF, a part of cells were postive for AE1/AE3 and identified as CTCs after immuncytochemistry analysis in situ further.Here,we have found a way to detect CTCs in CNHCs-UMF.Though this method,cytomorphological infornation and immunological information could be taken together to reach a more credible judgement in the field of CTCs detection. Its application could pave the way for research on the relevance of CTCs detection and its clinical prognostic significance in patients with non-small cell lung cancer carcinoma or other solid carcinoma
Keywords： kCirculating tumor cells;ISET;Morphology;Immunocytochenmistry in situ;NSCLC

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