宫颈癌肿瘤细胞再增殖与近距离放疗剂量间关系的动态监测

DYNAMIC CHECK OF CERVICAL CARCINOMA BRACHYTHERAPY DOSE AND TUMOR CELL REPOULATION

目的 :通过对同一宫颈癌患者放疗前、放疗 2周 10 Gy、4周 2 0 Gy连续宫颈肿物活检 ,Ki6 7、增殖细胞核抗原 (PCNA)、突变型 p5 3(mtp5 3)等增殖指标检测 ,探讨在后装分次放疗过程中加速再增殖出现时间。方法 :运用流式细胞仪行 Ki6 7抗原检测及细胞周期分析 S期比例 (SPF)、增殖指数 (PI)、DNA异倍体 (DEN) ,用免疫组化方法和计算机图像分析仪定量分析 PCNA、mtp5 3蛋白表达情况 ,观察各增殖指标随剂量增加时变化规律。结果 :Ki6 7、PCNA、mtp5 3抗原表达及 DEN随放疗剂量的增加、疗程的延长而明显增加 ,其中 Ki6 7、PCNA、mtp5 310Gy时与放疗前比较有统计学意义 ,与 2 0 Gy时比较差异无统计学意义。结论 :肿瘤细胞加速再增殖在宫颈癌后装分次放疗后 2周 10 Gy时已经出现 ,而 10 Gy与 2 0 Gy时各指标差异不明显 ,提示肿瘤细胞增殖速度稳定 。

Objective:To explore the relationship between the accelerated repopulation of tumor cells in the afterloading fractionated radiation therapy and the radiation dose,Ki67 antigen,PcNA & mutation p53 antigen expression were analyzed by continual biopsy on the same patients of cervical carcinoma two weeks (10 Gy)and four weeks(20 Gy).Methods:Ki67 antigen expression and cell cycle analysis (SPF,PI,DEN) were checked by flow cytometry,PCEA & mutation p53 antigen expression were checked by means of immunohistochemical technique and computerized image cytometry.All these indexes were viewed on their relationship with the irradiation dose.Rusults:Ki67 antigen expression and DEN were increased as radiation dose increased.The difference of Ki67,PCNA and mtP53 antigen expression at the dose of 10 Gy had statistical significance compared with before brachytherapy,but it had no statistical significance compared with at the dose of 20 Gy.Conclusion:It may be concluded that the tumor cell repopulation had occurred at the dose of 10 Gy (two weeks after brachytherapy).But these markers were not obviously changed compared with at the dose of 20 Gy,so it leads to a conclusion that tumor cell repopulation was stable.It also offers the theory basis to select the opportunity of accelerated brachytherapy of cervical carcinoma.