术前不同剂量碘^(131)治疗对甲状腺癌细胞的杀伤效应及对唾液腺功能的影响

Killing effects of different doses of preoperative iodine 131 therapy on thyroid cancer cells and its effect on salivary gland function

目的:研究术前不同剂量碘1 3 1治疗对甲状腺癌细胞的杀伤效应及对唾液腺功能的影响。方法:将2013年5月~2014年6月在南充市中心医院确诊为甲状腺癌的患者纳入研究,接受术前碘131治疗并随机分为对照组、小剂量组、中剂量组、高剂量组,检测甲状腺癌组织中的细胞凋亡率、细胞周期、促癌基因和抑癌基因的表达以及唾液腺功能。结果:(1)癌细胞杀伤效应:与对照组比较,低剂量组、中剂量组和高剂量组的细胞凋亡率以及G0/G1期细胞数目增多,S期和G2/M期细胞数目减少,BRAF、Livin、MCM7、CDK2表达量降低,CCNG2、PTEN表达量增加;中剂量组和高剂量组的细胞杀伤效应优于低剂量组,且中剂量组和高剂量组的细胞杀伤效应无差异;(2)唾液腺功能:与对照组比较,低剂量组、中剂量组和高剂量组双侧腮腺、双侧颌下腺的UI和SR降低;低剂量组和中剂量组对唾液腺的损伤效应弱于高剂量组,且低剂量组和中剂量组的唾液腺损伤效应无差异。结论:中剂量碘131能够同时兼顾对癌细胞的杀伤作用以及对唾液腺的保护作用,是甲状腺癌患者术前碘131内照射治疗的理想剂量。

Objective：To study the killing effects of different doses of preoperative iodine ^131 therapy on thyroid cancer cells and its effect on salivary gland function. Methods： Patients diagnosed with thyroid cancer in our hospital from May 2013 to June 2014 were enrolled and given preoperative iodine ^131 therapy. Then they were randomly divided into control group, low dose group, middle dose group and high close group. Then cell apoptotic rate, cell cycle, cancer promoting gene and cancer suppressor gene expression in thyroid carcinoma tissue as well as salivary gland function were detected. Results： （1） cancer cell killing effects： compared with control group, cell apoptotic rates and number of cells in G0/G1 phase of low dose group, middle dose group and high dose group increased, number of cells in S and G2/M phase decreased, BRAF, Livin, MCM7 and CDK2 expression decreased, CCNG2 and PTEN expression increased. Cell killing effects of the middle dose group and high dose group were better than that of low dose group, and cell killing effect of middle dose group and high dose group were not significant different;（2） Salivary gland function., compared with control group, UI and SR in bilateral parotid and bilateral submandibular glands of low dose group, middle dose group and high dose group decreased. Salivary gland damage effects of low dose group and middle dose group were weaker than that of high dose group, and salivary gland damage effect of low dose group and middle dose group were not significant different. Conclusion： Middle dose of iodine ^131 shows both killing effects on cancer cells and the protective effects on salivary glands; it＇s an ideal dosage for preoperative iodine ^131 internal radiation therapy among thyroid cancer patients.