替莫唑胺联合放疗对体外原代培养的胶质瘤细胞Ki-67表达的影响  

Effect of radiotherapy combined with temozolomide on Ki-67 expression levels in primary cultured malignant glioma cells

作　　者：吴科[1] 唐树军[1] 魏剑波[1] 黄志刚[1] 王代文[1] 

机构地区：[1]攀枝花市中心医院神经外科,四川617000

出　　处：《中国临床神经外科杂志》2017年第5期322-324,共3页Chinese Journal of Clinical Neurosurgery

基　　金：四川省卫生厅科研基金项目(110503)

摘　　要：目的探讨替莫唑胺同步放化疗对脑神经胶质瘤病人生存质量的影响以及放疗联合替莫唑胺处理对体外原代培养胶质瘤细胞Ki-67表达的影响。方法 2013年10月至2016年8月收治恶性脑神经胶质瘤114例,分为对照组(n=57)与观察组(n=57)。所有病人均接受手术治疗。对照组术后4周接受安慰剂+放疗;观察组在放疗基础上采用替莫唑胺同步化疗。对照组和观察组术中各留取两份肿瘤组织,一份4 h后直接测定Ki-67表达情况。对照组另一份经放疗处理后测定Ki-67表达情况。观察组另一份经过替莫唑胺放、化疗处理后测定Ki-67表达。结果治疗前,观察组和对照组生存质量评分分别为(32.67±3.32)分、(32.69±3.29)分,两组无统计学差异(P>0.05)。治疗后,观察组和对照组生存质量评分分别为(43.40±3.26)分、(38.37±5.99)分,较治疗前均明显增高(P<0.05),而且,观察组增加更明显(P<0.05)。两组不良反应总发生率无统计学差异(P>0.05)。放、化疗两处理前,观察组和对照组Ki-67阳性表达率分别为71.93(41/57)、73.68(42/57),两组无统计学差异(P>0.05)。放、化疗两处理前,观察组Ki-67阳性表达率(24.56%,14/57)明显低于对照组(43.68%,25/57;P<0.05)。结论替莫唑胺同步放化疗可显著改善脑神经胶质瘤病人生存质量,可能与降低Ki-67表达水平有关。Objective To investigate the effect of postoperative radiotherapy and simultaneous temozolomide on the survival quality in the patients with gliomas and treatment of radiotherapy combined with temozolomide on Ki-67 expression levels in primary cultured malignant glioma cells. Methods One hundred and fourteen patients with malignant cerebral gliomas were randomly divided into two groups, i.e. control group （n=57）, in which the patients received radiotherapy and observed group （n=57）, in which the patients received chemotherapy with temozolomide on the basis of radiotherapy after the surgery for the gliomas. The gliomas tissues derived from the patients of each group were divided into two equal parts, of which, one as used for determination of Ki-67 expression and the other for the tissues culture. The cultured glioma tissues were derived into two groups, i.e. radiotherapy group, in which Ki-67 expression was determined in the cultured tissues after the radiotherapy and radiochemotherapy group in which Ki-67 expression was determined in the cultured tissues after the radiotherapy and chemotherapy with temozolomide. The survival quality was assessed by survival quality score before and after the treatment in all the patients. Results The survival quality scores [（43.40±3.26） points] were significantly higher in the observed group than that [（38.37±5.99） points] in control group after the treatment （P〈0.05）. The positive rate of Ki-67 expression （24.6%） was significantly lower in the radiochemotherapy group than that （43.86%） in the radiotherapy group （P〈0.05）. There was insignificant difference in the incidences of adverse reactions between the observed group and control groups （P〉0.05）. Conclusions It is suggested that the radiotherapy combined with chemotherapy with temozolomide may increase the survival quality in the patients with malignant gliomas and decrease Ki-67 positive expression in the gliomas tissues.

关 键 词：脑神经胶质瘤 同步放化疗 替莫唑胺 生存质量 Ki-67 

分 类 号：R739.41[医药卫生—肿瘤]