模拟调强技术照射鼻咽低分化鳞癌细胞的生物效应机制研究

Objective To study the altered radiobiological effect of simulative intensity-modulated radiotherapy (SIMR) in cultured human nasopharyngeal carcinoma (NPC) cells and the related mechanism. Methods Single cell suspension of exponentially growing CNE-2 cells, a poor differentiated NPC cell line, was seeded and cultured for 12 hours, then the cells were irradiated in two different models by 6 MV X-ray beams at 3 Gy/min. In single fraction irradiation (SFR) model, cells were irradiated a single fraction of 0, 2, 4, 6 or 8 Gy within 0 to 3 minutes. In S1MR model, cells were irradiated 0, 2, 4, 6 or 8 Gy in 5 frac-tions with interval of 8.0-8.5 minutes between. Clonogenic assay was performed to determine the radiosen-sitivity. Cellular apoptosis was measured by flow cytometry. RT-PCR was used to detect mRNA expressions of Bax and Bcl-2, Respectively. Results Compared with SFR group, the survival fraction in SIMR group was higher at all the dose levels. The values of α, β, D0 and Dq were higher in SIMR group than in SFR group. At dose levels of 2 Gy, 4 Gy and 6 Gy, The early and late apoptotic cells in SIMR group were lower than in SFR group (21.20%: 15.89%, F=18.51, P=0.020;13.00%: 10.20, F=15.67, P=0.040).The mRNA expression of Bax was upregulated in a dose-dependent manner in the both groups. Compared with SFR group, the mRNA expression of Bax in SIMR group was lower at all the dose levels (Mean value of 76.75% : 62.50%, F =36.57, P =0.000). Bcl-2 mRNA expression at every dose level had no significant difference between the two groups (Mean value of 29.25% : 29.75%, F=0.74, P=0.800). Conclusions Prolonged delivery time in SIMR model can decrease the radiobiological effects.     

介入加放疗综合治疗6例晚期下咽癌临床报道

下咽癌是头颈部比较常见的恶性肿瘤，约占头颈部恶性肿瘤的0．8％～2．5％，由于解剖结构特殊，治疗上首先放疗。放疗后5年生存率约50％，晚期病例仅为10％～20％。我们对6例晚期下咽癌放疗前中进行选择性动脉灌注化疗，受到很好效果，现报告如下。     

经典型Kaposi,s肉瘤放射治疗加生物治疗

 目的　分析了 8例Kaposi,s肉瘤 (KS)的临床特点和放疗加生物治疗的疗效。方法　采用6 0 钴或加速器 χ线和电子线混合射线常规分割照射 ,总量 36～ 6 1Gy。生物疗法包括LAK细胞和干扰素、免疫核糖核酸。结果　除例 1放疗后 2个月死于糖尿病、例 6失访外 ,其余均获长期生存。生存 1年以上 6 /8,3年以上 4 /8,5年以上 2 /8。结论　放射线治疗对KS有效 ,较晚期根治剂量以 5 0Gy左右为宜 ,同时加生物治疗可能可以提高疗效。     

K i67在621例乳腺癌患者各亚型中的表达及临床意义

目的：分析K i67指数在各分子分型乳腺癌组织中的表达水平及临床意义。方法回顾性分析该院2013年1月至2013年12月收治的621例乳腺浸润性导管癌患者的临床病理资料,通过免疫组织化学（IHC）方法测定雌激素受体（ER）、孕激素受体（PR）、表皮生长因子受体-2（HER-2）及Ki67的表达情况以区分不同的分子亚型。结果621例女性乳腺浸润性导管癌患者的K i67指数为0％～95％,平均为40．83％。以14％为界,将乳腺癌患者的K i67指数分为两组,其中,K i67指数小于或等于14％乳腺癌患者109例（17．6％）,K i67＞14％乳腺癌患者512例（82．4％）。患者年龄、肿瘤大小、淋巴结转移状态、肿瘤病理分期与Ki67指数均无关（均 P＞0．05）。患者组织学分级、ER状态、PR状态、HER-2状态与Ki67指数均有关（均 P＜0．01）。Luminal A型、Luminal B型、HER-2过表达型、三阴性患者的Ki67指数分别为10．00％、40．00％、40．00％、70．00％,其中,其他三型的Ki67指数均明显高于Luminal A型（均 P＜0．01）,Luminal B型、HER-2过表达型、三阴性三者之间的Ki67指数比较差异有统计学意义（ P＜0．05）。三阴性乳腺癌患者的K i67指数（70．00％）显著高于非三阴性乳腺癌患者（30．00％）。结论 K i67与乳腺癌的临床病理特征有一定的相关性,与ER、PR、HER-2同时检测可能对判断乳腺癌预后有重要意义。     

食管癌患者血浆外泌体蛋白标志物TMT定量蛋白质组学筛选及分析

目的 探讨食管癌患者血浆外泌体蛋白的表达变化,筛选并分析食管癌诊断的生物标志物.方法 采用定量蛋白质组学串联质量标签(TMT)标记技术对3例食管鳞状细胞癌患者及3例健康体检者的血浆外泌体蛋白进行检测及定量分析,筛选食管癌患者血清外泌体中发生显著性变化的差异蛋白.采用Proteome Discoverer、STRING等数据库对差异蛋白进行生物信息学分析.结果 共鉴定出17种显著差异表达蛋白,其中显著上调蛋白6个,显著下调蛋白11个.GO功能注释、COG注释、KEGG通路注释和结构域注释显示差异蛋白主要包括蛋白酶抑制剂的羧肽酶、细胞外基质1、分泌磷蛋白24、ERV/ALR硫代氧化酶、血小板反应蛋白/软骨寡聚基质蛋白的卷曲螺旋结构域、胎球蛋白B半胱氨酸蛋白酶抑制结构域.结论 定量蛋白质组学TMT法能有效筛选食管癌患者血浆外泌体中的差异蛋白,筛选出的差异蛋白有望成为食管癌诊断的标志物.     

乳腺癌术后放疗联合复方苦参注射液治疗对患者免疫功能及生存质量的影响

目的：观察术后放疗联合复方苦参注射液治疗乳腺癌的临床疗效及其对患者细胞免疫功能及生活质量的影响,为临床乳腺癌患者术后治疗提供有力依据。方法回顾性分析我院乳腺放疗科2013年1月至2014年12月收治的128例术后放疗乳腺癌患者的临床诊治资料,其中术后放疗者64例为对照组,术后放疗联合复方苦参注射液静脉滴注者64例为观察组,共治疗6个月。于治疗前及治疗6个月后第二天检测两组患者的细胞免疫功能,比较两组患者美容效果、生活质量和不良反应。结果治疗6个月后观察组患者的CD3+、CD4+、NK细胞及CD4+/CD8+值较治疗前明显提高[(65.7±6.9) vs (58.3±8.1)、(38.7±4.9±6.9) vs (24.5±3.0)、(65.6±8.3)%vs (39.6±5.3)%、(1.18±0.21) vs (0.59±0.14)],而CD8+值较治疗前明显下降[(31.0±2.9) vs (42.7±4.5)],差异均有统计学意义(P<0.05);对照组患者的CD8+及NK细胞数较治疗前稍增加[(43.3±4.4) vs (42.1±4.9)、[(41.3±5.8)%vs (40.1±5.1)%],其他指标较治疗前略下降,差异均无统计学意义(P>0.05);观察组患者的美容优良率为92.2%(59/64),略优于对照组89.1%(57/64),差异无统计学意义(P>0.05);观察组患者的生存质量改善者52例(81.3%),明显高于对照组30例(46.9%),差异有统计学意义(P<0.05);观察组患者的皮肤反应和骨髓抑制明显优于对照组,差异均有统计学意义(P<0.01)。结论术后应用复方苦参注射液联合放疗治疗乳腺癌,其可减少不良反应,增强患者细胞免疫功能,且术后不会对乳房美容效果产生较大影响,有利于改善患者生活质量。     

调强放疗模式下食管癌患者急性放射性肺损伤的影响因素分析

目的 探讨调强放射治疗模式下食管癌患者出现急性放射性肺损伤的影响因素。方法 回顾分析2014 年1月—2016年12月在新疆医科大学附属肿瘤医院接受调强放疗的食管癌患者233例, 按照是否发生急性放射性肺损伤分组, 对发生放射性肺损伤的影响因素进行预测分析。临床资料包括年龄、 性别、 T分期、 淋巴结有无转移、 病理类型、 病变位置、 病变长度、 化疗模式、 KPS评分、 基础肺疾病、 糖尿病、 吸烟史; 物理学参数包括双肺V5、 V10、 V15、 V20、 V30、 全肺平均剂量 （MLD）、 肿瘤靶区 （GTV） 体积、 两肺体积、 GTV体积与两肺体积比值、 放射野数、 处方剂量。采用Logistic回归分析筛选放射性肺损伤的危险因素。结果 233例患者中63例 （27%） 出现急性放射性肺损伤, 其中≥2级急性放射性肺损伤25例 （10.7%）。急性RILI组与无RILI组间淋巴结转移、 GTV体积、 GTV体积与两肺体积比值、 MLD、 双肺V5、 V10、 V15、 V20、 V30、 处方剂量比较差异有统计学意义。多因素分析显示, 双肺V5≥63.15% （OR= 1.022, 95%CI： 1.003～1.041）、 V30≥5.35% （OR=2.693, 95%CI： 1.159～6.010） 是发生急性放射性肺损伤的危险因素（P＜0.05）。结论 评估食管癌调强放疗治疗计划时, 应充分考虑临床特征、 双肺V5、 V30等物理学指标, 尽量降低放射性肺损伤的风险。     

模拟调强技术照射鼻咽低分化鳞癌细胞的生物效应机制研究

Objective To study the altered radiobiological effect of simulative intensity-modulated radiotherapy (SIMR) in cultured human nasopharyngeal carcinoma (NPC) cells and the related mechanism. Methods Single cell suspension of exponentially growing CNE-2 cells, a poor differentiated NPC cell line, was seeded and cultured for 12 hours, then the cells were irradiated in two different models by 6 MV X-ray beams at 3 Gy/min. In single fraction irradiation (SFR) model, cells were irradiated a single fraction of 0, 2, 4, 6 or 8 Gy within 0 to 3 minutes. In S1MR model, cells were irradiated 0, 2, 4, 6 or 8 Gy in 5 frac-tions with interval of 8.0-8.5 minutes between. Clonogenic assay was performed to determine the radiosen-sitivity. Cellular apoptosis was measured by flow cytometry. RT-PCR was used to detect mRNA expressions of Bax and Bcl-2, Respectively. Results Compared with SFR group, the survival fraction in SIMR group was higher at all the dose levels. The values of α, β, D0 and Dq were higher in SIMR group than in SFR group. At dose levels of 2 Gy, 4 Gy and 6 Gy, The early and late apoptotic cells in SIMR group were lower than in SFR group (21.20%: 15.89%, F=18.51, P=0.020;13.00%: 10.20, F=15.67, P=0.040).The mRNA expression of Bax was upregulated in a dose-dependent manner in the both groups. Compared with SFR group, the mRNA expression of Bax in SIMR group was lower at all the dose levels (Mean value of 76.75% : 62.50%, F =36.57, P =0.000). Bcl-2 mRNA expression at every dose level had no significant difference between the two groups (Mean value of 29.25% : 29.75%, F=0.74, P=0.800). Conclusions Prolonged delivery time in SIMR model can decrease the radiobiological effects.     

模拟调强技术照射鼻咽低分化鳞癌细胞的生物效应机制研究

Objective To study the altered radiobiological effect of simulative intensity-modulated radiotherapy (SIMR) in cultured human nasopharyngeal carcinoma (NPC) cells and the related mechanism. Methods Single cell suspension of exponentially growing CNE-2 cells, a poor differentiated NPC cell line, was seeded and cultured for 12 hours, then the cells were irradiated in two different models by 6 MV X-ray beams at 3 Gy/min. In single fraction irradiation (SFR) model, cells were irradiated a single fraction of 0, 2, 4, 6 or 8 Gy within 0 to 3 minutes. In S1MR model, cells were irradiated 0, 2, 4, 6 or 8 Gy in 5 frac-tions with interval of 8.0-8.5 minutes between. Clonogenic assay was performed to determine the radiosen-sitivity. Cellular apoptosis was measured by flow cytometry. RT-PCR was used to detect mRNA expressions of Bax and Bcl-2, Respectively. Results Compared with SFR group, the survival fraction in SIMR group was higher at all the dose levels. The values of α, β, D0 and Dq were higher in SIMR group than in SFR group. At dose levels of 2 Gy, 4 Gy and 6 Gy, The early and late apoptotic cells in SIMR group were lower than in SFR group (21.20%: 15.89%, F=18.51, P=0.020;13.00%: 10.20, F=15.67, P=0.040).The mRNA expression of Bax was upregulated in a dose-dependent manner in the both groups. Compared with SFR group, the mRNA expression of Bax in SIMR group was lower at all the dose levels (Mean value of 76.75% : 62.50%, F =36.57, P =0.000). Bcl-2 mRNA expression at every dose level had no significant difference between the two groups (Mean value of 29.25% : 29.75%, F=0.74, P=0.800). Conclusions Prolonged delivery time in SIMR model can decrease the radiobiological effects.     

乳腺癌保乳术后常规与三维适形调强放疗剂量学比较

目的:乳腺癌保乳术后放疗的通常采用常规切线野技术,现调强放射治疗(intensity-modulated radiotherapy,IMRT)技术有望在保障相同疗效的同时进一步减少放疗并发症,提高生活质量.本研究利用三维计划系统评价全乳IMRT的剂量学优势与适应证.方法:选择20例接受保乳手术Tis-2NOMO早期乳腺癌病例,利用三维适形治疗计划系统为每例患者设计切线野常规计划与IMRT计划,处方剂量均为5000cGY,用剂量体积直方图评价靶区剂量均匀度及正常组织如肺、心脏所受剂量来比较两种计划.结果:靶区覆盖率在两种计划中相似,分别为98%和99%.与常规计划比较,IMRT计划的PTV接受105%处方剂量从19%降至7.7%;110%处方剂量从3.6%降至0.3l%;心脏的V30(接受30Gy照射的体积百分比)分别为4.6%±4.3%和12.7%±6.3%(P<0.001);V40(接受40Gy照射的体积百分比)分别为1.5%±2.1%和8.3%±4.1%(P<0.001).结论:两种靶区剂量均匀度有统计学意义.全乳IMRT的剂量学优势主要在于保证靶区覆盖率的前提下,显著改善靶区的剂量分布均匀性并一定程度上降低邻近危及器官的受照剂量与容积.