DNA 倍体类型与鼻咽癌放射敏感性及预后关系的研究

 目的 探讨DNA倍体类型与鼻咽癌放射敏感性及预后的关系。方法 应用流式细胞术(FCM)分析45例放疗前鼻咽癌细胞的DNA倍体，放疗结束六个月评定疗效。对患者进行定期随访，分析DNA倍体性与鼻咽癌放射敏感性及预后有无相关性。结果 DNA倍体性与鼻咽癌临床分期、近期疗效、放射敏感性及预后均有明显的相关性，但与性别、病理类型无关。早期肿瘤(Ⅰ+Ⅱ期)的DNA异倍体率为11．11％(2／18)远低于晚期(Ⅲ+Ⅳ期)者的40．74％(11／27)(P<0．05)，异倍体肿瘤较二倍体肿瘤对放疗更敏感(P<0．01)，且异倍体肿瘤的近期疗效明显好于二倍体肿瘤(P<0．05)，但异倍体肿瘤的预后较二倍体肿瘤差(P<0．01)。结论 DNA倍体类型可作为评估鼻咽癌放射敏感性和预后的一个独立指标。FCM的肿瘤细胞DNA倍体分析可能成为鼻咽癌选择放疗分割方案的客观指标。

Relationship between DNA-ploidy and Radiosensitivity and Prognosis of Nasopharyngeal Carcinoma

Objective 　To explore the correlation between DNA-ploidy and radiosensitivity and prognosis of nasopharyngeal carcinoma ( NPC ) . Methods 　The DNA-ploidy of 45 cases NPC cells was analyzed before the radiotherapy by means of FCM. The short-term curative effect was assessed in the sixth month after the radiotherapy was end up . The patient s were followed up periodically af ter the t reatment . And the relationship between DNA-ploidy and radiosensitivity and prognosis was then statistically analyzed . Results 　There was no relationship between DNA-ploidy and the sex and pathologic type. But there was a remarkable correlation between DNA-ploidy and the following factors : clinical stage , short-term curative effect , radiosensitivity and prognosis. The percentage of the DNA aneuploidy in early stage ( Ⅰ+ Ⅱstage) was 11. 11 %(2/ 18) , while in late stage ( Ⅲ+ Ⅳstage) it was 40. 74 %(11/ 27) ( P < 0. 05) . The aneuploidy tumors were more radiosensitive than the diploidy tumors ( P < 0. 01) and the short-term curative effect of the aneuploidy tumors was much better than that of the diploidy tumors ( P < 0. 05) . But the prognosis of the aneuploidy tumors were much more poor than that of the diploidy tumors ( P < 0. 01) . Conclusion 　Based on these findings , DNA-ploidy is considered as an independent factor of radiosensitivity and prognosis for NPC. The analysis of DNA-ploidy by means of FCM may be as an objective index to choose different divide-up radiotherapy for each individual patient of NPC.