高剂量率后装腔内放射治疗48例宫颈癌的病理学研究

Histopathologic Study in 48 Cases of Uterine Cervix Carcinoma with High Dose Rate Irradiation

目的 探讨高剂量率后装腔内治疗的疗效。方法 回顾性分析 48例行单纯根治性放疗的Ⅱb～Ⅲb期宫颈癌患者 ,在行直线加速器体外照射加高剂量后装腔内放射治疗后 ,对放射线的反应程度 ,并采用免疫组化S P法检测放射治疗前宫颈癌组织增殖细胞核抗原指数 (PI)。结果 鳞癌 41例中 ,呈Ⅲ级放疗反应者占 70 .7% ( 2 9/4 1) ,腺癌 7例中 ,呈Ⅲ级放疗反应者占 2 8.6 %( 2 /7) ,有显著性差异 (P <0 .0 5 )。PI≥ 30 %者 5年生存率为 40 .0 % ,PI <30 %者 5年生存率为 76 .9% (P <0 .0 1)。结论 从病理学角度分析宫颈癌治疗的近期疗效再联合PCNA的检测 。

Objective To evalute the optimal regiment of cervical carcinoma treated by the combination of after loading irradiaton with improve its effectiveness.Methods A retrospective study was performed in 48 patients(stage Ⅱb and Ⅲb) treated by extemal irradiation with linear accelerator and intracavitary brachythecapy.The radiation induced damage were compared between cervical squamous carcinome and adencarcinoma.Proliferating cell nuclear antigen index(PI) was detected immunohistochemically before radiotherapy,and compared with each other.Results The Irradiation respone of grade Ⅲ was 29 of 41(70.7%) in squamous cell carcinoma,and 2 of 7 in adenocacinoma and adenosquamous carcinoma.The difference was statistically significant( P <0.05).Five year survival rate was 76.9% in patients with PI≥30% and 40.0% in patients with PI<30%( P <0.01).Conclusion Short term theraputic effect plus the detection of PCNA expression may be of value to predict the prognosis of patients with cervical cancer.