头颈部恶性肿瘤患者放疗前外周血淋巴细胞核内γ-H2AX焦点数与放疗后急性放射性损伤程度相关性研究

Study on the relativity of nuclear γ-H2AX foci number of peripheral blood lymphocytes with acute radiation injury after chemotherapy in patients with head and neck malignancies

目的探讨头颈部恶性肿瘤患者放疗前外周血淋巴细胞核内γ-H2AX焦点数与放疗后急性放射性黏膜和皮肤反应程度的相关性。方法选择2010年12月至2012年3月湖北三峡职业技术学院附属医院收治的34例头颈部恶性肿瘤初诊患者,采集其外周血进行1Gy的6MV-X线照射,通过细胞免疫荧光技术检测淋巴细胞核内γ-H2AX焦点数;同时追踪观察所有患者放疗后出现急性放射性黏膜和皮肤反应的情况,探寻其与外周血淋巴细胞核内γ-H2AX焦点数之间的相关性。结果 34例患者中,出现急性放射性黏膜反应Ⅰ级6例(占17.65%),Ⅱ级19例(占55.88%),Ⅲ级8例(占23.53%),Ⅳ级1例(占2.94%);出现急性放射性皮肤损伤Ⅰ级9例(占26.47%),Ⅱ级12例(占35.29%),Ⅲ级13例(占38.24%)。急性放射性黏膜和皮肤反应程度与患者外周血淋巴细胞核内γ-H2AX焦点数的水平均呈正相关(r=0.815,P<0.05;r=0.888,P<0.05)。结论头颈部恶性肿瘤患者放疗前检测外周血淋巴细胞核内γ-H2AX焦点数的水平可作为预测放疗后急性放射性黏膜和皮肤反应发生风险大小及严重程度的客观生物学指标。

Objective To study the relativity of nuclear γ-H2 AX foci number of peripheral blood lymphocytes with acute radiation injury after chemotherapy in patients with head and neck malignancies.Methods Totally 34 patients with head and neck malignancies were selected in this study. The blood samples were collected and given 1Gy dose of radiation immediately,γ-H2 AX foci number of peripheral blood lymphocytes was detected after 3 hours by immunofluorescence. Acute mucositis and dermatitis of patients were observed after receiving radiotherapy.Results In 34 patients,6 cases（17.65%）acute radiation mucositis grade I,19 cases（55.85%）grade Ⅱ,8 cases（23.53%）grade Ⅲ,and 1 case（2.92%）grade Ⅳ;9 cases（26.47%）acute radiation dermatitis grade Ⅰ,12 cases（35.29%）grade Ⅱ,13 cases（38.24%）grade III.The presence of acute mucositis and dermatitis correlated significantly with γ-H2 AX foci detection in peripheral blood lymphocytes（r = 0.815,P〈0.05;r = 0.888,P〈0.05）.Conclusionγ-H2 AX foci number of pe-powerful tool to predict radiation-induced mucositis and dermatitis.