子宫颈鳞癌和腺癌的放射敏感性比较

The Comparison of Radiosensitivity Between Uterine Cervical Squamous Carcinoma and Adenocarcinoma

目的比较子宫颈鳞癌和腺癌的放射敏感性。方法二次后装治疗后，比较宫颈鳞癌和腺癌肿瘤缩小和肿瘤细胞放射性损伤程度，同时用免疫组织化学ＡＢＣ法检测放射治疗前后宫颈鳞癌和腺癌的增殖细胞核抗原指数（ＰＩ）并进行比较。结果二次后装治疗后，宫颈鳞癌局部肿瘤缩小≥５０％者占７０％（２１／３０），腺癌为２７％（４／１５），差异有极显著性（Ｐ＜０．０１）。宫颈鳞癌放射性损伤为Ⅱｂ～Ⅲ级者占６０％（１８／３０），腺癌为２０％（３／１５），差异有显著性（Ｐ＜０．０５）；宫颈鳞癌放射治疗后ＰＩ从５３５０％±４３４％降至３９３０％±４０２％，差异有极显著性（Ｐ＜０．００１），而腺癌ＰＩ自３５４７％±３８３％降至３１８０％±３０６％，差异无显著性（Ｐ＞０．０５）。结论宫颈鳞癌放射敏感性高于腺癌，放射过程中ＰＩ的降低，可能是宫颈鳞癌放射敏感性的生物学基础。

Objective To compare the radiosensitivity of uterine cervical squamous carcinoma and adenocarcinoma. Methods The shrinkage of tumor and the radiation induced damage were compared between cervical squamous carcinoma and adenocarcinoma after twice afterloading radiotherapy. Proliferating cell nuclear antigen index (PI), detected immunohistochemically, was compared before and after radiotherapy between the two tumors. Results Patients of squamous carcinoma with tumor shrinkage 50% or more accounted for 70% (21/30) and patients of adenocarcinoma accounted for 27% (4/15), which was statistically significant ( P <0.01) The radiation induced damage grade Ⅱb～Ⅲ accounted for 60% (18/30) in squamous carcinoma and for 20% (3/15)in adenocarcinoma, which was statistically significant ( P <0.05); PI decreased from 53.50%±4.34% to 39.30%± 4.02% after radiotherapy in squamous carcinoma ( P <0.001), while PI decreased from 35.47%±3.83% to 31.80%±3.06% in adenocarcinoma ( P >0.05). Conclusions The radiosensitivity of cervical squamous carcinoma is higher than that of adenocarcinoma. The decrease of PI after radiotherapy may be a biological basis of radiosensitivity for uterine cervical squamous carcinoma.