探讨叶酸受体阳性循环肿瘤细胞检测在早期肺腺癌辅助诊断及手术效果评估中的应用价值。

收集153例经CT检查发现肺结节或肺部肿物且在术后经病理活检确诊为肺腺癌患者的术前及术后EDTA抗凝血6 mL、100例肺部良性疾病患者的EDTA抗凝血6 mL进行叶酸受体阳性循环肿瘤细胞检测。收集实验数据及患者的临床资料并应用SPSS 16.0进行数据分析，以P＜0.05为差异有统计学意义。

153例早期肺腺癌患者术前与100例肺部良性疾病患者的叶酸受体阳性循环肿瘤细胞的平均水平分别为(9.73±5.69)FU、(8.93±5.60)FU，P＞0.05；肺腺癌患者术前与术后的叶酸受体阳性循环肿瘤细胞的平均水平分别为(9.73±5.69)FU、(7.68±3.41)FU，P＜0.05。性别、年龄、结节大小和数量均与肺腺癌患者的叶酸受体阳性循环肿瘤细胞水平差异无统计学意义(P＞0.05)。以叶酸受体阳性循环肿瘤细胞水平作为肺癌的诊断指标，其ROC曲线下面积为0.564 (95% CI为0.491~0.637)，当截断点为8.5 FU时，诊断灵敏度为49.7%、特异度为66.0%。

叶酸受体阳性循环肿瘤细胞水平用于肺腺癌患者早期诊断的价值较低，建议结合其他检验项目或影像学报告进行联合诊断。肺腺癌患者的叶酸受体阳性循环肿瘤细胞水平在术后下降，可作为肺腺癌患者手术成效的评估指标。本研究暂未发现肺腺癌患者的叶酸受体阳性循环肿瘤细胞水平与年龄、性别、结节大小、数量等指标的相关性。

To investigate the application value of folate receptor-positive circulating tumor cells detection in the diagnosis and surgical effect evaluation of pulmonary adenocarcinoma.

A total of 153 patients with pulmonary adenocarcinoma who were confirmed by CT image and/or pathological biopsy and 100 benign pulmonary diseases patients were enrolled in the study. The amount of 6 mL venous blood was collected from both groups to detect the level of folate receptor-positive circulating tumor cells. The experimental data and clinical data were collected and analyzed by SPSS 16.0 and P＜0.05 was considered that there are significant differences.

The mean folate receptor-positive circulating tumor cells level of pulmonary adenocarcinoma patients and benign pulmonary diseases patients were (9.73±5.69)FU and (8.93±5.60)FU, respectively (P＞0.05). The mean level of folate receptor-positive circulating tumor cells in patients with pulmonary adenocarcinoma before and after biopsy operation were (9.73±5.69)FU and (7.68±3.41)FU, respectively (P＜0.05). Gender, age, the size and number of nodule were not significantly correlated with the level of folate receptor positive circulating tumor cells in patients with pulmonary adenocarcinoma (P＞0.05). The area under the ROC curve (AUC ROC) of blood folate receptor-positive circulating tumor cells level for the diagnosis of pulmonary adenocarcinoma was 0.564 (95% CI:0.491~0.637), When the cut off value was set at 8.5 FU, sensitivity was 49.7%、specificity was 66.0%.

It was not so ideal to use folate receptor-positive circulating tumor cells level for early diagnosis of pulmonary adenocarcinoma. The mean folate receptor-positive circulating tumor cells level was decreased after operation, which can be used as an indicator of the outcome of pulmonary adenocarcinoma. In this study, no correlation was found between the level of folate receptor positive circulating tumor cells and age, gender, nodule size and number in patients with pulmonary adenocarcinoma.