放疗前后鼻咽癌患者淋巴细胞损伤的研究

目的研究放射治疗对鼻咽癌患者外周血淋巴细胞的损伤效应，探讨染色体畸变率和HPRT基因位点突变成为辐射生物剂量计的可行性。方法对鼻咽癌患者放疗前后外周血淋巴细胞染色体畸变率、HPRT基因位点突变频率分别进行检测分析。结果鼻咽癌患者放疗前外周血淋巴细胞染色体畸变率、HPRT基因位点突变频率与对照组及放疗后相比差异均有显著统计学意义。结论外周血淋巴细胞染色体畸变率、HPRT基因突变频率联合进行检测可望成为评价放疗致机体遗传学损伤的辐射生物剂量计。     

鼻咽癌放疗后放射性脑病及生活质量研究

目的分析广东地区鼻咽癌放疗后放射性脑病（radiation encephalopathy，RE）的临床和影像学特点，并对放射性脑病患者生存质量的变化及其影响因素进行研究。方法分析89例RE患者的临床资料，采用世界卫生组织生存质量量表简表（WHOQOL-BREF）、LENT／SOMA放射性损伤评估量表对33例RE患者（病例组）和34例疗程匹配的鼻咽癌放疗后无放射性脑病患者（对照组）进行评定，系统分析放射性脑病患者生存质量的变化、影响因素及与神经系统症状的相关性。结果二程放疗后6个月内RE的发生率较一程放疗者差异有统计学意义；首发症状以球麻痹症状（33例，37．07％）最常见；病例组在社会关系、总的健康和总的生活评分方面低于对照组（P〈0．05）；二程放疗者较一程放疗者在总的健康评分、总的生活评分、生理因素和心理因素评分低（P〈0．05）。球麻痹症状与生活质量心理因素、总的生活和健康评分呈负相关（P〈0．05），头痛、神经功能障碍也分别与生活质量等的评分呈负相关。结论再程放疗后放射性脑损伤出现的潜伏期明显缩短。除环境因素外，放射性脑病对生命质量的其他方面存在一定的负性影响。球麻痹症状的存在对生存质量产生了较大的负性影响。     

鼻咽癌放疗后脑神经损伤的MRI表现

目的 探讨鼻咽癌放疗后脑神经损伤的原因及其MRI表现.方法 选择临床和MRI资料完整的36例患者进行回顾性分析,采用1.5T MR行头颅、鼻咽部横轴位、冠状位和矢状位平扫以及增强扫描成像,对MRI图像进行分析.结果 ①脑神经第Ⅵ、Ⅴ、Ⅹ、Ⅻ对损害占前四位;②鼻咽癌局部复发引起脑神经损伤17例,单纯放射性神经损害12例,复发与放射性脑病并存的7例.结论 鼻咽癌放疗后脑神经损伤有肿瘤复发、放射性脑病和两者共存三方面原因.MRI检查能早期、准确显示脑神经损伤.     

放射性脑病的临床CT分析（附24例报告）

放射性脑病的临床ＣＴ分析（附２４例报告）暨南大学医学院附属医院医学影像科李恒国，李启权放射性脑病是头颈部恶性肿瘤放射治疗后较为严重的并发症。鼻咽癌是我国南方常见的恶性肿瘤，占头颈部肿瘤的５０％以上￣［１］，故放射性脑病常见于鼻咽癌放疗后。我们收集了２...     

鼻咽癌放疗后腔外肿块残留或复发的MR诊断

目的 :探讨鼻咽癌放疗后腔外肿块残留或复发的MR特点。方法 :回顾性分析了鼻咽癌放疗后鼻咽腔无肿块、腔外肿块存留或复发的 2 0例MR检查资料。结果 :咽旁间隙肿块 11例 ;颅底骨质破坏 17例 ;海绵窦受侵犯 11例、后颅窝肿块 3例 ;眼眶侵犯 2例 ;副鼻窦及鼻腔异常 15例 ;放射性脑病 4例。结论 :MR是诊断鼻咽癌放疗后咽旁肿瘤残存或复发的有效方法     

鼻咽癌的放射性脑病

鼻咽癌的放射性脑病田培林放射治疗是鼻咽癌最有效的治疗方法，而与鼻咽部毗邻的脑组织在放疗中易受损害，尤以大脑的预叶，这种自射线引起的大脑损伤称放射性脑病（以下称放脑病）。本病常被误诊为脑转移而误治。作者对１２例放脑病进行了分析。１临床资料鼻咽癌（均为低...     

鼻咽癌放射治疗后血管损伤的研究进展

鼻咽癌是中国南方和东南亚地区常见的头颈部恶性肿瘤,而且60％～90％鼻咽癌患者出现颈部淋巴结转移.放射治疗目前仍是鼻咽癌主要治疗方法,然而,鼻咽癌患者常规颈部放疗后血管损伤可能与放疗后鼻咽部顽固性出血、放射性脑病有关.近期研究表明,鼻咽癌放疗后年轻患者缺血性卒中危险性增高.鼻咽癌放射治疗后血管损伤方面的研究将提高相关科室医务人员对该病变的认识,从而惠利于患者.     

鼻咽癌放疗后放射性脑病的MRI特征

目的：探讨鼻咽癌放疗后放射性脑病（REP）的磁共振（MRI）形态学表现特征，并探讨其诊断价值。方法：对66例放射性脑病的MRI资料进行回顾性分析。结果-REP的发生以颗叶多见，66例REP中累及单侧颞叶12例，双侧颞叶54例。其特征性表现为：（1）指状水肿并局限性坏死：T1WI为指状低信号，12WI为高信号，T1WI＋Gd-FYFPA增强呈脑回状或环形强化。（2）囊性变：T1WI为类圆形水样低信号，T2WI为高信号，T1WI＋Gd-DTPA增强囊壁略强化。（3）占位效应明显。结论：鼻咽癌放疗后REP的MRI表现具有特征性，可作为REP诊断的主要方法。     

鼻咽癌患者放射性口腔黏膜反应护理干预效果分析

目的探讨护理干预对鼻咽癌患者放射性口腔黏膜反应的影响。方法对我科2009年1月至2011年12月收治的120例鼻咽癌患者随机分为观察组与对照组各60例。对照组按护理常规进行对症护理。观察组在放疗前、放疗中、放疗后实施系统的护理干预,观察两组的护理结果。结果对照组患者中有10例因严重口腔黏膜反应放弃治疗。观察组60例患者均顺利完成放疗,放射性口腔炎的发生率和严重程度均明显低于对照组,差异具有显著性(P<0.05)。结论护理干预能有效预防或减轻鼻咽癌患者放疗所致的放射性口腔炎。     

MRI在鼻咽癌放疗后随访中的应用价值

目的:探讨MRI在鼻咽癌放疗后随访中的应用价值。方法:72例鼻咽癌放疗后病人,均行MRI扫描,其中32例行Gd-DTPA强化扫描。结果:局部软组织肿块33例,颅底骨质破坏49例,肌肉受累23例,淋巴结增大25例,放射性脑病12例,27例鼻咽部出现放疗后纤维化表现。结论:MRI在鼻咽癌放疗后随访中具有明显优势。     

Translocation frequencies measured in patients one year after radioactive iodine therapy for thyrotoxicosis

Purpose : To investigate the incidence of translocations induced by iodine-131 therapy in thyrotoxicosis patients 1 year after the administration of the radiolabelled compound. Materials and methods : Tricolour FISH with whole-chromosome-specific probes for chromosomes 2, 4 and 8 was used for scoring translocations. From the genomic translocation frequencies, derived using the Lucas formula, equivalent whole-body doses were calculated, based on the in vitro 60 Co γ-ray dose-response curve. Results : A total of 101 translocations were observed in 4864 metaphases, 63% being of the two-way type. In the control group used for obtaining dose-response data, nine translocations were observed in 5278 metaphases, 55% being two-way translocations. No correlation was found between the observed frequency of translocations and administered radioactivity. Using the in vitro dose-response, an estimated average dose for the group of nine patients of 0.79 ±0.22Gy was obtained. Compared with frequencies following the assumption that the involvement of a particular chromosome in a two-break exchange-type aberration is proportional to its DNA content, chromosome 4 was more frequently involved and chromosomes 2 and 8 less frequently involved in chromosomal rearrangements. Conclusion : This study shows that 131 I therapy for thyrotoxicosis patients induced translocations, especially in chromosome 4, which could be detected 1 year after the administration of the radiolabelled compound.     

Translocation frequencies measured in patients one year after radioactive iodine therapy for thyrotoxicosis

PURPOSE: To investigate the incidence of translocations induced by iodine-131 therapy in thyrotoxicosis patients 1 year after the administration of the radiolabelled compound. MATERIALS AND METHODS: Tricolour FISH with whole-chromosome-specific probes for chromosomes 2, 4 and 8 was used for scoring translocations. From the genomic translocation frequencies, derived using the Lucas formula, equivalent whole-body doses were calculated, based on the in vitro (60)Co gamma-ray dose-response curve. RESULTS: A total of 101 translocations were observed in 4864 metaphases, 63% being of the two-way type. In the control group used for obtaining dose-response data, nine translocations were observed in 5278 metaphases, 55% being two-way translocations. No correlation was found between the observed frequency of translocations and administered radioactivity. Using the in vitro dose-response, an estimated average dose for the group of nine patients of 0.79 +/- 0.22Gy was obtained. Compared with frequencies following the assumption that the involvement of a particular chromosome in a two-break exchange-type aberration is proportional to its DNA content, chromosome 4 was more frequently involved and chromosomes 2 and 8 less frequently involved in chromosomal rearrangements. CONCLUSION: This study shows that (131)I therapy for thyrotoxicosis patients induced translocations, especially in chromosome 4, which could be detected 1 year after the administration of the radiolabelled compound.     

深圳市2015—2020年放射工作人员上岗前职业健康检查染色体畸变率与微核率分析

目的 分析深圳市2015—2020年放射工作人员上岗前职业健康检查染色体畸变率与微核率的水平及其分布特征,为加强放射工作人员辐射防护和职业健康管理提供科学依据。 方法 选取2015—2020年在深圳市职业病防治院接受上岗前职业健康检查的2 777名放射工作人员开展横断面研究,其中男性2 210名、女性567名,年龄17~69（27.6±6.8）岁,将受检者按年龄分为5组:17~20岁、21~30岁、31~40岁、41~50岁、51~69岁。采用全血微量培养法制备受检者的淋巴细胞微核和染色体,应用全自动染色体扫描分析系统对每名受检者的100个淋巴细胞染色体中期分裂相进行分析,统计双着丝粒体、着丝粒环和无着丝粒体等染色体畸变类型,比较不同年龄组以及同年龄组不同性别受检者染色体畸变情况和微核情况的差异。计量资料的组间比较采用方差分析;染色体畸变和微核的分布服从泊松分布,采用非参数检验,2组间比较采用Mann-Whitney U检验,多组间比较采用Kruskal-Wallis秩和检验。受检者年龄与染色体畸变率、微核率的相关性分析采用Spearman秩相关分析。 结果 2 777名受检者的染色体畸变（双着丝粒体+着丝粒环+无着丝粒体）率为（0.072±0.005）%、双着丝粒体+着丝粒环畸变率为（0.016±0.002）%、染色体畸变细胞率为（0.068±0.005）%、微核率为（0.43±0.01）‰、微核细胞率为（0.40±0.01）‰、淋巴细胞转化率为（85.07±3.16）%。各年龄组间染色体畸变率、双着丝粒体+着丝粒环畸变率、染色体畸变细胞率以及各年龄组不同性别受检者的染色体畸变率、染色体畸变细胞率间的差异均无统计学意义（χ2=1.193、0.931、0.691,Z=?0.929~?0.059,均P>0.05）。与17~20岁年龄组相比,其余各年龄组受检者的微核率、微核细胞率均较高,淋巴细胞转化率均较低,且差异均有统计学意义（Z=?6.981~?2.510,F=4.922~52.860,均P<0.05）;受检者的微核率和微核细胞率均与年龄呈正相关（r=0.166、0.168,均P<0.001）,而淋巴细胞转化率与年龄呈负相关（r=?0.197,P<0.001）;21~30岁年龄组、31~40岁年龄组女性受检者的微核率、微核细胞率以及17~20岁年龄组、21~30岁年龄组女性受检者的淋巴细胞转化率均显著高于同年龄组的男性受检者,且差异均有统计学意义（Z=?4.826~?3.516,F=6.947、14.563,均P<0.01）。 结论 深圳市2015—2020年放射工作人员上岗前职业健康检查染色体畸变率与微核率均未超过国内文献报道的健康人群的本底水平范围,但有随年龄增大而升高的趋势,需加强放射工作人员的辐射防护与职业健康管理。     

Modification of X-ray induced chromosome aberration frequency by pre- and postirradiation hyperthermia of human peripheral lymphocytes.

Human peripheral lymphocytes (HPL) were used to study the synergistic effects of hyperthermia and X-irradiation. The effects on the chromosome aberration frequencies of different combinations of heat and radiation exposure at different cell cycle phases were analysed at the first mitosis after irradiation. When unstimulated HPL were heated after irradiation with 2 and 3 Gy, respectively, the chromosomal aberration frequencies were significantly higher than following radiation exposure alone. Heat treatment during different phases of the cell cycle and irradiation during the G2 phase led to an increase in the aberration frequencies when the cells were heat-treated not later than 16 h before radiation. Furthermore we show that the number of breaks increased linearly with the duration of hyperthermia when HPL were heated for periods of 1-15 min at 45 degrees C 32 h before irradiation at 48 h after stimulation. Heat treatment alone during any phase of the cell cycle did not induce chromosome aberrations. The increased aberration frequencies are probably the result of inhibited repair of radiation-induced DNA strand breaks.     

Modification of X-ray Induced Chromosome Aberration Frequency by Pre- and Postirradiation Hyperthermia of Human Peripheral Lymphocytes

Summary

Human peripheral lymphocytes (HPL) were used to study the synergistic effects of hyperthermia and X-irradiation. The effects on the chromosome aberration frequencies of different combinations of heat and radiation exposure at different cell cycle phases were analysed at the first mitosis after irradiation. When unstimulated HPL were heated after irradiation with 2 and 3 Gy, respectively, the chromosomal aberration frequencies were significantly higher than following radiation exposure alone. Heat treatment during different phases of the cell cycle and irradiation during the G₂ phase led to an increase in the aberration frequencies when the cells were heat-treated not later than 16 h before radiation. Furthermore we show that the number of breaks increased linearly with the duration of hyperthermia when HPL were heated for periods of 1–15 min at 45°C 32 h before irradiation at 48 h after stimulation. Heat treatment alone during any phase of the cell cycle did not induce chromosome aberrations. The increased aberration frequencies are probably the result of inhibited repair of radiation-induced DNA strand breaks.     

钍尘职业暴露工人外周血淋巴细胞染色体畸变的研究

目的 研究含钍稀土混合粉尘对职业暴露人员外周血淋巴细胞染色体畸变的影响。方法 采用常规吉姆萨染色方法分析53名钍尘作业工人及58名非接尘工人(对照组)的染色体非稳定性畸变,荧光原位杂交方法分析10名钍尘作业工人及11名非接尘工人的染色体稳定性畸变。结果 接尘组的畸变细胞、双着丝粒+环和总畸变率显著高于对照组(χ²=4.12,P<0.05; χ²=5.07,P<0.05; χ²=7.09,P<0.01)。无着丝粒的畸变率在接尘组与对照组间差异无统计学意义。接尘组的易位率(4.5±2.0)与对照组的易位率(3.8±1.7)比较差异无统计学意义(Z=-0.566,P>0.05)。结论 长期职业暴露于含钍稀土混合粉尘能够增加染色体的非稳定性畸变,未观察到易位率增加。     

乳癌病人单次卡铂和阿霉素化疗诱发的染色体损伤和细胞生物学毒性

应用常规染色体畸变分析和胞浆分裂阻滞微核（ｃｙｔｏｋｉｎｅｓｉｓｂｌｏｃｋｍｉｃｒｏｎｕｃｌｅｉ，ＣＢＭＮ）法对１０例接受单次卡铂（平均剂量为４６２．９ｍｇ／ｍ２）和单次阿霉素（平均剂量为４８．１ｍｇ／ｍ２）化疗的乳癌病人血样进行了淋巴细胞染色体畸变（ｃｈｒｏｍｏｓｏｍｅａｂｅｒａｔｉｏｎ，ＣＡ）和微核（ｍｉｃｒｏｎｕｃｌｅｉ，ＭＮ）的观察分析，并通过有丝分裂指数（ｍｉｔｏｔｉｃｉｎｄｅｘ，ＭＩ）及核分裂指数（ｎｕｃｌｅａｒｄｉｖｉｓｉｏｎｉｎｄｅｘ，ＮＤＩ）观测了细胞毒性。结果表明，单次卡铂和阿霉素化疗均引起了ＣＡ和ＭＮ显著性增加，所观察到的ＣＡ主要为单体畸变，其中单体间隙（ｃｈｒｏｍａｔｉｄｇａｐ，ｃｔｇ）的增加最为显著，染色体型畸变未见显著性变化；卡铂引起ＭＩ明显减低，阿霉素对ＭＩ的影响不显著；两种化疗药物均未对ＮＤＩ产生显著性影响；通过ＭＩ及ＮＤＩ测量的细胞毒性之间显著性相关，但ＣＡ分析和ＣＢＭＮ法测得的染色体损伤之间缺乏相关性。     

A comparative study of dose distribution of a high-energy electron beam and chromosome aberration frequencies

Electron beam therapy is usually employed for the treatment of tumours located at or near the surface of the body, because the electron beam gives a high dose near the surface, but falls off rapidly with increasing depth beyond the level of the 80% depth dose. Isodose curves for radiotherapy have been obtained using physical methods, but have rarely been investigated on the basis of living human cells. In the present study, lymphocyte chromosome analysis was employed as a biological dosemeter for comparison with the isodose curve measured physically. The peripheral blood was exposed to a 14 MeV electron beam in a plastic tube set in a specially made test-tube stand immersed in a water tank. The chromosome aberration frequencies induced by irradiation of about 95% of peak dose at a depth of 31 mm were found to be higher in value than those induced at a depth of 17 mm where the peak dose had been determined physically. Three gray of irradiation given to whole blood in the presence of contrast medium gave rise to a slight enhancement of radiation-induced chromosome aberration frequencies in the lymphocytes exposed at a depth of 17 mm, but a slight decrease at 31 mm.     

放射工作人员染色体畸变研究现状

长期暴露于低剂量电离辐射会对放射工作人员的辐射敏感组织器官造成损伤。目前,常用于评价慢性低剂量电离辐射所致辐射损伤的主要细胞遗传学指标是外周血淋巴细胞染色体畸变。本文对国内外放射工作人员暴露于低剂量电离辐射所致细胞遗传学效应的调查和研究进行综述,了解目前放射工作人员外周血淋巴细胞染色体畸变检测的现状及存在的问题,为国内开展放射工作人员染色体畸变检测与评价提供参考。