肺癌患者DNA断裂修复能力差异表现及临床意义

DIFFERENCE OF REPAIRING DNA BREAK CAPABILITY IN CELLS OF LUNG CANCER PATIENTS AND ITS CLINICAL MEANING

目的 :探讨肺癌患者细胞DNA断裂修复能力差异的存在及其临床意义。方法 :博莱霉素 (BLM )体外攻击人培养淋巴细胞 ,计数染色体断裂率 (b/c) ,观察低修复型和正常修复型患者接受放化疗后的反应。结果 :①肺癌患者b/c平均值为 1.0 2±0 .72 ,低修复型患者 5 2 % ,极低修复型患者 37% ;②显示随年龄组升高 ,低修复型显著升高 (P <0 .0 5 ) ;③低修复型患者一年复发转移率 31% ,略高于正常修复型患者 2 3 % ;临床出现毒副反应者中低修复型占 78%。结论 :随年龄增大 ,患者细胞DNA断裂修复能力下降。肺癌发生与细胞DNA修复能力的下降有正相关性。低修复型个体更易复发转移 ,放化疗中较易出现临床毒副反应。修复能力的检测有望成为一项较为实用的个体化治疗生物学指标。

Purpose: To investigate the difference of repairing DNA breaks in cells of lung cancer patients and its clinical expression. Methods: The cultures of human lymphocytes were treated with blemycin, and the number of chromatid breaks per cell (b/c) was recorded. The effects of patients with higher and lower DNA repair capability treated with radiotherapy or chemotherapy were observed. Results: ①Mean value of b/c in lung cancer patients was 1.02, with standard deviation of 0.72. Fifty two percent were low DNA repair capability class; of them, 37% were extremely low repair capability class. ②Low DNA repair capability class increased remarkably with the groups of increased age (P<0.05). ③The frequency of recurrence and metastasis in low DNA repair capability class was 31%, higher than 23% in normal DNA repair capability class. Of patients appearing clinical side and toxical effects, 78% were those in low DNA repair capability class. Conclusion: DNA repair capability in cells of lung cancer patients decreased with the increase of age. Low DNA repair capability class is susceptible to recurrence and metastasis, and appearing side toxical effects when treated with radiotherapy and chemotherapy. DNA repair capability in cells is expected to become a biological marker in individual specific treatment.