The presence of metastases in mediastinal lymph nodes (LNs) is essential for planning lung cancer treatment and assessing anticancer immune responses. The aim of the study was to assess LNs for the presence of neoplastic cells and evaluate lung cancer-selected antigen expression. LN aspirates were obtained during an EBUS/TBNA procedure. The cells were analyzed using a hematological analyzer and flow cytometry. It was possible to indicate the presence of cells characterized by high fluorescence connected with high metabolic activity using a hematological analyzer and to determine their non-hematopoietic origin using flow cytometry. Using these methods together, we detected very quickly a high proportion of cancer cells in LNs. We noticed that it was possible to determine a high expression of EpCAM, TTF-1, Ki67, cytokeratin, HER, and differences between non-small-cell (NSCLC) and small-cell lung cancer (SCLC) for the antigens MUC-1, CD56, HLA-DR, CD39, CD184, PD-L1, PD-L2 and CTLA-4 on tumor cells. We report, for the first time, that the detection of tumor cells in LNs with the expression of specific antigens is easy to evaluate using a hematological analyzer and flow cytometry in EBUS/TBNA samples. Such precise characteristics of non-hematopoietic cells in LNs may be of great diagnostic importance in the detection of micrometastases.
纵隔淋巴结（LNs）是否存在转移对肺癌治疗方案的制定及抗癌免疫反应的评估至关重要。本研究旨在评估淋巴结中肿瘤细胞的存在情况并分析肺癌特异性抗原的表达。通过超声支气管镜引导下经支气管针吸活检（EBUS/TBNA）获取淋巴结穿刺样本，采用血液分析仪和流式细胞术对细胞进行分析。通过血液分析仪可检测到具有高荧光特性（与高代谢活性相关）的细胞群，并借助流式细胞术确认其非造血来源。联合应用这两种方法，我们能够快速检测到淋巴结中高比例的癌细胞。研究发现，可明确检测到肿瘤细胞表面EpCAM、TTF-1、Ki67、细胞角蛋白、HER的高表达，并在非小细胞肺癌（NSCLC）与小细胞肺癌（SCLC）之间观察到MUC-1、CD56、HLA-DR、CD39、CD184、PD-L1、PD-L2及CTLA-4等抗原的表达差异。本研究首次证实，通过血液分析仪与流式细胞术对EBUS/TBNA样本进行分析，可便捷评估淋巴结中携带特定抗原的肿瘤细胞。这种对淋巴结非造血细胞的精准表征，在微转移检测中具有重要的诊断价值。
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