宫颈癌辐射抵抗机制的相关研究进展

Research progress on radioresistance mechanism of cervical cancer

宫颈癌是女性生殖系统最常见的恶性肿瘤,中晚期及早期宫颈癌术后有高危因素需补充治疗,均以放疗为主。提高宫颈癌对辐射的敏感性一直是妇科肿瘤医生亟须解决的问题。近年研究发现,宫颈癌辐射抵抗与肿瘤干细胞、DNA损伤修复、肿瘤微环境等密切相关。肿瘤干细胞引起辐射抵抗的机制主要有上皮间质转化、乏氧、氧化调节、细胞内吞噬、炎症反应等;DNA损伤修复通路相关因子如共济失调毛细血管扩张突变基因、ATM-Rad3相关蛋白激酶及与通路相互作用的基因可能成为提高放疗敏感性的靶点;肿瘤微环境中的一些因子对宫颈癌辐射抵抗产生作用。上述各种因素之间相互关联、相互作用,其具体的作用机制影响宫颈癌对放疗的敏感性及疗效,本文对宫颈癌辐射抵抗机制的相关研究进展作一综述。

Cervical cancer is the most common malignant tumor of female reproductive system,middle and advanced stage and postoperative high-risk factors of early cervical cancer need supplementary treatment,mainly radiotherapy.Improving the sensitivity of cervical cancer to radiation has always been an urgent problem for gynecological oncologists.Recent studies have found that radioresistance of cervical cancer is closely related to cancer stem cell,DNA damage repair,and tumor microenvironment.The mechanisms of radioresistance induced by cancer stem cell include epithelial-mesenchymal transformation,hypoxia,oxidative regulation,intracellular phagocytosis,and inflammatory reaction,etc.Factors related to DNA damage repair pathway,such as ataxic telangiectasia-mutant gene,ATM-Rad3-related protein kinase,and genes interacting with the pathway,may be targets for improving radiotherapy sensitivity.Some factors in tumor microenvironment play a role in radioresistance of cervical cancer.The above factors are interrelated and interact with each other,and their specific mechanism of action affects the sensitivity and efficacy of radiotherapy for cervical cancer.This paper reviews the research progress on the mechanism of radioresistance of cervical cancer.