改良“彗星”分析法检测鼻咽癌放射敏感性的初步研究  

Modified comet assay prediction of radiosensitivity in 105 nasopharyngeal cancer patients

作　　者：高黎[1] 杨伟志[1] 袁智勇[1] 徐国镇[1] 高远红[1] 王冕荣[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤研究所肿瘤医院放射治疗科,北京100021

出　　处：《中华放射肿瘤学杂志》2004年第1期39-43,共5页Chinese Journal of Radiation Oncology

基　　金：首都发展基金资助项目 (2 0 0 2 3 0 0 7)

摘　　要：目的　评价改良”彗星”分析法应用于预测临床鼻咽癌放射敏感性的价值。方法　应用改良”彗星”分析法对 10 5例鼻咽癌患者放射治疗前的鼻咽活检组织标本进行分析。将鼻咽癌活检标本制备的单细胞悬液分为对照管和单次 5Gy照射管。所有病例在放射治疗前及至 5 0Gy时行螺旋CT或MRI检查 ,分别测量肿瘤最大横截面积 (S0 为疗前 ,S50 为疗中至 5 0Gy时 )。临床放射敏感性评价应用肿瘤最大横截面积的消退率表示 [即Rs=(S0 S50 ) /S0 ],Rs≥ 0 .9为高度敏感 ,0 .7≤Rs<0 .9为中度敏感 ,Rs<0 .7为不敏感。实验室根据图像特点将”彗星”图分为ⅠA、ⅠB、ⅡA、ⅡB四类 ,根据尾力矩、DNA积分吸光度等参数设定实验室放射敏感性判断标准。统计分析采用SPSS10 .0软件包 ,用Kappa分析法进行临床和实验室结果一致性分析。结果　全组患者临床放射敏感性高度敏感 4 1例 ,中度敏感 2 1例 ,低敏感 4 3例。改良”彗星”分析法放射敏感性敏感 5 8例 ,不敏感 4 7例。改良”彗星”分析法的敏感性为 71.0 % ,特异性为 6 7.4 % ,准确性为 6 9.5 %。两种检测方法接近中高度一致性(Kappa=0 .38)。结论　改良”彗星”分析法检测人鼻咽癌活检标本 ,在放射治疗前能对鼻咽癌的临床放射敏感性作出预测 ,方法简单、检测周期短 。ObjectiveTo evaluate the value of modified comet assay for predicting clinical radiosensitivity of nasopharyngeal cancers(NPC). MethodsBiopsy samples were collected and analyzed by alkaline comet assay in 105 NPC patients before radiotherapy. The biopsy material from the primary tumor,having been prepared as isolated cell suspension,was divided into two items: control and 5 Gy per fraction irradiation. All tumors had been examined by spiral CT or MRI before treatment and up untill 50 Gy of radiation by conventional fraction,so as to measured the S 0 and S 50 of the maximum tumor cross-section area. Regression rate was used to evaluate the clinical tumor radiosensitivity,and expressed as regression ratio (R s= [S 0-S 50 ] /S 0). The tumor radiosensitivity was set as high sensitivity (R s≥0.9),intermediate sensitivity (0.7≤R s<0.9)and insensitivity (R s<0.7). According to the cell DNA photos in modified comet assay,ⅠA、ⅠB、ⅡA、ⅡB graphs were classified and the radiosensitivity was decided by the value of R TM and absorption of light density(A). Statistical analysis software SPSS10.0 was used. Kappa analytical method was used for consistency test between clinical results and laboratory results. Results In the assay of clinical radiosensitivity,41 highly sensitive ,21 intermediate sensitive and 43 low sensitive tumors were found. In the modified comet assay,58 sensitive and 47 insensitive tumors were found. The sensitivity ,specificity and accuracy were 71.0%, 67.4% and 69.5%. The results of modified comet assay were similar to the clinical results in 73 patients. Kappa analytical result neared moderate-high consistency(Kappa=0.38) between modified comet assay and clinical radiosensitivity. Conclusions Our study demonstrates that evident correlation is present between results of modified comet assay and clinical radiosensitivity of NPC. The modified comet assay is potentially favored in clinical application due to its convenience and short cycle of assay.

关 键 词：“彗星”分析法 检测 鼻咽癌 放射敏感性 放射治疗 

分 类 号：R739.63[医药卫生—肿瘤]