鼻咽癌放射治疗引起眼角膜内皮细胞面积变异

Nasopharyngeal carcinoma radiotherapy induced corneal endothelial cell size variation

目的探讨鼻咽癌患者实施放射治疗与角膜内皮细胞面积变异的关系。方法回顾分析2007年1月~2009年12月间就诊于我院行放射治疗的103例鼻咽癌患者的临床资料。根据接受放射剂量的不同分成4组（A组：≤30 Gy;B组：31~50 Gy;C组：51~70 Gy;D组：〉70 Gy）。分别记录每组治疗前,治疗后1 d、1周、1个月、6个月、1年、2年的角膜内皮细胞面积变异系数,通过分析放射治疗前后角膜内皮细胞面积变异来评估放射剂量对角膜内皮细胞的影响。结果患者的年龄差异无统计学意义（P〉0.05）。当放射剂量≤50 Gy（A组和B组）时,角膜内皮细胞变异系数增大不明显,随访中观察能恢复到治疗前水平;当放射剂量〉50 Gy（C组和D组）时,角膜内皮细胞变异系数明显增大,且不能恢复到治疗前水平。结论鼻咽癌患者放射治疗后角膜内皮细胞变异系数的变化与年龄无明显关系。角膜内皮细胞面积的变异与放射剂量有关,当放射剂量达到阈值后,角膜内皮细胞面积将发生严重变异,甚至导致严重的角膜病变。

Objective To investigate the impact of radiotherapy on the variation coefficient of corneal endothelial cell area in nasopharyngeal carcinoma patients and to explore the dose-effect relationship between them. Methods A retrospective study was done for 103 patients who received radiation therapy for nasopharyngeal carcinoma. The patients were divided into four groups according to different radiation doses. The corneal endothelial coefficients of variation were recorded for each group at before pre-treatment and 1 day, 1 week, 1 month, 6 months, 1 year, 2 years after the treatment. The effect of radiation dose on corneal endothelial ceils was assessed through analyzing the changes of corneal endothelial ceils coefficient of variation before and after the treatment. Results The difference of age was not statistically significant （P 〉 0.05）. When the radiation dose was less than or equal to 50 Gy （ group A and group B）, the corneal endothelial cells coefficient of variation slightly increased, which could be recovered to the pre-treatment level during follow-up. When the radiation dose was more than 50 Gy （group C and group D）, the corneal endothelial ceils was significantly increased which could not be recovered to the pre-treatment level during follow-up. Conclusions Changes in variation coefficient of corneal endothelial cell area of patients who have received radiation therapy for nasopharyngeal carcinoma have no significant relationship with age. Variation of corneal endothelial cell area was related to radiation dose. When the dose reaches the threshold, corneal endothelial cell area will vary, and even lead to serious corneal disease.