A preliminary study on the detection of specific circulating lung cancer cells by flow cytometry for nonsmall cell lung cancer

Objective To explore the clinical application value of flow cytometry in detecting specific circulating lung cancer cell (SCLCC) for non-small cell lung cancer (NSCLC). Methods The flow cytometry was established by fluorescent monoclonal antibody NJ001 which can specific recognize the SPC-A1.On basis of detecting the SCLCC,a case-control study was conducted.43 NSCLC patients were compared with 15 benign lung disease patients and 35 healthy controls from the First Affiliated Hospital of Nanjing Medical University by rank-sum test.The difference was also evaluated between before and after surgery for 25 NSCLC patients.The data were analyzed by ROC curve to assess the diagnostic value.Meanwhile,CEA,CYFRA21-1 and NSE were measured by ECLIA for comparison with SCLCC in 43 NSCLC patients by chi-square test. Results The levels of SCLCC in patients of NSCLC,benign lung disease and healthy controls were 75 (16- 128) /200 000 PBMC,5 (0-30) /200 000 PBMC,0 (0- 15)/200 000 PBMC.The SCLCC of NSCLC patients were obviously higher than that of benign lung disease patients and healthy controls (Z=-3.373,-5.240,P<0.05).According to ROC curve,the area under the curve was 0.831 and the optimal diagnostic critical value was 30/200 000 PBMC,with higher sensitivity (65%) and specificity (92%).The levels of SCLCC before and after surgery in 25 NSCLC patients were 78 (12-120)/200 000 PBMC and 17 (0-104)/200 000 PBMC.There were significant differences between them (Z=-2.005,P<0.05).Meanwhile,the positive rate of SCLCC in NSCLC was 65%,and obviously higher than the positive rate of CEA (35%,χ2=5.76,P<0.05),CYFRA21-1 (14%,χ2=16.96,P<0.05) and NSE (23%,χ2=13.14,P<0.05). Conclusion Determination of SCLCC by flow cytometry for NSCLC had higher sensitivity,specificity and clinical value,which suggested that it is a valuable detection technology for NSCLC.(Chin J Lab Med,2013,36:1002-1007) Key words: Lung neoplasms; Carcinoma; non-small-cell lung; Neoplasm circulation cells; Flow cytometry