PDF(Pubmed)
Abstract：
A 77-year-old man was admitted at our hospital due to \"generalized increase in the number of masses and enlargement of the masses observed for one month\". Combined assessment of the imaging (computed tomography and magnetic resonance imaging) findings and results of lung centesis biopsy and liquid biopsy suggest that the patient had small cell lung cancer of the left upper lobe, with right hilar, mediastinal, bilateral axillary, abdominal and retroperitoneal lymph node metastases, as well as widespread subcutaneous soft tissue, liver, bilateral adrenal, bilateral kidneys and multiple brain metastases (extensive stage). In order to obtain an evaluation of the development of the disease as soon as possible, the circulating tumor cells (CTCs) and circulating tumor microemboli (CTM) in 6 mL peripheral blood were examined by subtraction enrichment-immunostaining fluorescence in situ hybridization (SE-iFISH) technology. A total of 919 epithelial cell adhesion molecule (EpCAM)-positive CTCs and 61 EpCAM-positive CTM were identified. Among them, there were 14 haploid CTCs (1.52%), 788 diploid CTCs (85.75%), 44 triploid CTCs (4.79%), 70 tetraploid CTCs (7.62%) and 3 pentaploid or higher-fold polyploid CTCs (0.33%). Herein, we reported a rare case with extremely high accounts of CTCs and CTM and positive findings for tumor markers, which was identified for the first time. The examination of CTCs by SE-iFISH contributed to the diagnosis, prognosis and treatment evaluation of cancer and facilitated the formulation of precise and individualized therapeutic regime.
摘要：
由于“一个月来观察到的群众数量普遍增加和群众扩大”，我们医院收治了一名77岁的男子。对影像学（计算机断层扫描和磁共振成像）的发现以及肺穿刺活检和液体活检的结果的综合评估表明患者患有左上叶小细胞肺癌，有了右边的hilar,纵隔,双侧腋窝，腹部和腹膜后淋巴结转移，以及广泛的皮下软组织，肝脏,双侧肾上腺,双侧肾脏和多发性脑转移（广泛阶段）。为了尽快获得对疾病发展的评估，采用减影富集-免疫染色荧光原位杂交(SE-iFISH)技术检测6mL外周血中的循环肿瘤细胞(CTC)和循环肿瘤微栓子(CTM).共鉴定出919个上皮细胞粘附分子(EpCAM)阳性CTC和61个EpCAM阳性CTM。其中,有14个单倍体CTC(1.52%)，788个二倍体CTC（85.75%），44个三倍体CTC（4.79％），70个四倍体CTC（7.62％）和3个五倍体或更高倍多倍体CTC（0.33％）。在这里，我们报道了一个罕见的病例，CTC和CTM的占比极高，肿瘤标志物呈阳性，这是第一次被确认。通过SE-iFISH检查CTC有助于诊断，癌症的预后和治疗评估，并促进了精确和个性化治疗方案的制定。
