鼻咽癌颈淋巴结转移病灶的血供与放射效应关系的研究

Analysis of the relationship between blood supply and radiation response of cervical lymph nodes metastased from nasopharyngeal carcinoma

目的了解鼻咽癌颈淋巴结转移病灶血供与其放射效应的关系。彩色多普勒超声测量肿瘤的血供是否可成为预测肿瘤放射效应方法。材料与方法观察６９个鼻咽癌患者颈淋巴结转移病灶的退缩程度及速度，采用彩色多普勒超声测量法测定颈淋巴结转移病灶放疗前血供情况。用多因素分析法分析其两者间的关系。结果共测量和观察了６９个鼻咽癌颈淋巴结转移病灶的血供和放射效应，逐步回归分析法示血供的好坏与病灶的退缩程度、速度呈正相关，表现为血供好的病理类型相对退缩好。其相关系数分别为６．４３９９，０．００４３，Ｐ值均＜０．１５有统计学意义。临床退缩好（坏）的两组淋巴结在不同疗程段的分析中一直未能显示与血供的好坏有相关性。结论血供是影响放射效应的一个独立因素，但不一定是主要因素。判断放射效应须多因素综合考虑。彩超法测量血供相对有许多优点，可用于临床帮助判断肿瘤的放射效应。

Purpose To evaluate the relationship of blood supply and radiation response of cervical lymph nodes metastased from nasopharyngeal carcinoma, aiming to know whether the blood supply is a valuable indicator for radiotherapy.Materials and Methods 69 metastatic cervical lymph nodes of nasopharyngeal carcinoma were studied with Color Doppler Flowing Imaging (CDFI) measuring the blood supply before irradiation. The tumor regression associated with radiation dose was clinically evaluated every week.Results Multivariate analysis(Stepwise Regression Analysis) showed that the lymph node regression was positively correlated with the blood supply. There was a tendency for the better blood supply with more tumor regression. Their parameters estimated were 6.4399 (regression degree) and 0.0043 (regression ratio),respectively (P<0.15). However, during different radiotherapy phases, the major responders (regression≥75%) and the minor responders (regression≤50%) were insignificantly different among the groups classified by blood supply (P>0.05).Conclusion It is indicated that the blood supply of cervical lymph nodes be an independent clinical indicator for their radiation response, but it may not be the dominant and predicative factor. CDFI is worth in measuring blood supply of tumors, especially the superficial lymph nodes.