摘要目的 初步探讨肝细胞肝癌外周血循环肿瘤细胞的检测效果.方法 收集50例经单纯手术切除治疗的肝细胞肝癌患者术前外周血,分别采用纳米磁珠负性富集和CaptorTM无标记捕获系统分离与富集外周血循环肿瘤细胞,采用上皮细胞和肝细胞肝癌组合标记的免疫荧光染色鉴定循环肿瘤细胞,探讨循环肿瘤细胞分离、富集和鉴定的效果,观察患者手术前后循环肿瘤细胞的数量变化.结果 纳米磁珠负性富集和CaptorTM无标记捕获系统均可有效分离和富集肝癌患者外周血循环肿瘤细胞.单纯手术治疗的肝细胞肝癌患者术前外周血经纳米磁珠负性富集后循环肿瘤细胞检出率为96.0％ (48/50),7.5ml外周血循环肿瘤细胞中位数为16个.术后7.5 ml外周血循环肿瘤细胞中位数为17个,术前为23个,差异有统计学意义(P =0.041).结论 采用纳米磁珠负性富集和CaptorTM无标记捕获系统均能有效分离和富集肝细胞肝癌外周血循环肿瘤细胞,手术前后循环肿瘤细胞数目存在差异,动态检测肝癌患者外周血循环肿瘤细胞可辅助了解肿瘤进展.

abstractsObjective To explore the detection efficiency of circulating tumor cells (CTCs) in patients with hepatocellular carcinoma (HCC).Methods Immunomagnetic negative enrichment by nanometer magnetic beads and label-free capture with CaptorTM system were used to isolate and enrich CTCs from peripheral blood of HCC patients,and epithelial and HCC markers were applied to identify CTCs by immunofluorescence staining.CTCs were detected in 50 HCC patients before and after hepatectomy to test the method for isolation,enrichment and identification.The dynamic changes of pre-and post-operative CTCs' numbers were compared.The clinical data were analyzed using SPSS 19.0 software.Results Negative enrichment methods by nanometer magnetic beads and label-free capture using CaptorTM system were both suitable for CTCs isolation and enrichment in HCC patients.The positive detection rate of CTCs in HCC patients via negative enrichment was 96.0％ (48/50),the preoperative median number of CTCs was 16 per 7.5 ml blood,and the postoperative median number was 17 per 7.5 ml blood.Conclusions Both negative enrichment and CaptorTM system are suitable for isolation and enrichment of CTCs in HCC patients.There is a significant difference in the numbers of CTCs before and after operation,and dynamic detection of CTCs will provide helpful prognostic information for HCC patients in clinics.