鼻咽癌放疗前、放疗中的细胞增殖动力学比较和意义

Comparison the dynamic of tumor clonogenic cells of nasopharygeal carcinoma before and during radiotherapy and its meaning

目的：探讨鼻咽癌放疗中是否存在肿瘤细胞的加速增殖，为鼻咽癌后程加速超分割治疗提供依据。方法：对放疗3－4周时的鼻咽癌行鼻咽纤维镜活检，利用自动图象分析仪对病理活俭阳性者进行疗前、疗中的细胞增殖动力学参数AgNORS的检测和自身前后计量对照。结果：共得到14对放疗前、放疗中3－4周时的AgNORS检测自身前后对照计量资料进行配对t检验，结果表明放疗中的各参数大于疗前的各参数，疗前、疗中平均每核AgNORS颗粒面积分别为10．19和15．28μm2，平均每核AgNORs颗粒数为12．61和18．09，AgNORs颗粒面积与核面积比值为0．141和0．200，平均每个AgNORs颗粒面积为2．60和3．49，差别具有显著性（P＝0．000～0．010）。结论：鼻咽癌放疗过程存在着肿瘤细胞加速再增殖，这时予以加量加速治疗具有一定的必要性。

Aims:To detect whether there is the accelerated proliferation of tumor clonogenic cell during Radiotherapy .of NPC. Metheds:The values of vary kinds of AgNORs parameters, such as the mean area Per nucleus, the mean total AgNORs area per nucleus, the mean AgNORs numbers per nucleus, the total AgNORs area divided by the total nucleolus area and the mean area per AgNORs, were measured in paraffin sections from 41 cases of NPC by automatic image analysis.Thirty-three cases of 41 cases took the second biopsy. Fourteen pairs of self-contrasted AgNORs parameters before and 3 to 4 weeks during radiotherapy were obtained. Results: The outcome of paired t-test showed that all the parameters before the treatment were lowers than 3 to 4 weeks during the therapy, 71. 69 vs 75. 79 μm2, 10. 19 vs 15. 28 μm2, 12. 61 vs18. 09, 0. 141 vs 0. 200, 2. 60 vs 3. 49 μm2 in turn, p=0. 000 ~0. 010. Condusion:The increase Of velocity and multiplication rate during the therapy become quicker than before the therapy. So, it is necessary to increase doses and fractions this time.