宫颈癌术野血经辐射后回输的临床前实验研究

Intraoperative Blood Salvage After Blood Irradiation in Cervical Cancer

目的 了解有效去除血中污染的宫颈癌细胞所需的辐射剂量。方法 对人类宫颈癌HeLa系细胞给予不同剂量梯度的γ线辐射,测定细胞生长抑制率及克隆形成抑制率,从而确定完全抑制HeLa细胞增生的最低有效辐射剂量。为了模拟临床实际情况,在体外将HeLa细胞与洗涤红细胞混合后给予有效剂量辐射,经密度梯度分离HeLa细胞并接种培养,用细胞集落形成检测其增生能力。取40份妇科恶性肿瘤病人的静脉全血,分别测定其在无辐射及予以有效剂量辐射后红细胞携氧功能指标2,3 DPG值。结果 12 Gy的辐射剂量能够完全抑制肿瘤细胞的增生(细胞生长抑制率及克隆形成抑制率均为100%,P<0.01),且不影响红细胞的携氧功能(不辐射与辐射后的2,3 DPG值无显著性差异,P>0.05)。结论 12 Gy的辐射剂量是彻底去除血中污染的宫颈癌细胞的最低有效辐射剂量,且不影响红细胞的携氧功能;为在宫颈癌手术中回收式自体输血(IAT)的临床应用提供了实验依据。

Objective To examine the minimum effective dosage of irradiation which can kill the cervical cancer cells in the blood. Methods Human cervical cancer cell lineHeLa cells were exposed to radiation in different dosage. The inhibitory rate of cell growth and colony were tested. HeLa cells were mixed with human red blood cells, and exposed to radiation. Then, these two kinds of cells were divided by density gradient centrifugation, and the rate of colony inhibition were tested. The blood samples were collected from 40 patients with different female malignancies, and 2,3-DPG—one of the functional indications of carrying oxygen by red blood cells, was tested after being exposed to irradiation or not. Results Either the cell growth inhibitory rate or the colony inhibitory rate of the HeLa cells was 100%(P<0.01) after being exposed to 12 Gy irradiation, meanwhile, the value of 2,3-DPG was nearly unchanged(P>0.05). Conclusion 12 Gy irradiation can kill the cervical cancer cells in the blood efficiently, and have no affection to carrying oxygen of red blood cells. The results above metioned provide the experimental data of intraoperative autotransfusion for the clinical trial in future.