SCGE、MNT与FCM对食管癌放疗患者外周血淋巴细胞损伤及不良反应的观察
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摘要
目的应用单细胞凝胶电泳法(Single Cell Gel Electrophoresis,SCGE)、微核试验(Micronucleus Test,MNT)和流式细胞技术(flow cytometry,FCM)分别检测放疗对食管癌患者外周血中淋巴细胞DNA损伤及T淋巴细胞亚群水平的变化情况,探讨放射剂量与外周血中淋巴细胞DNA损伤程度、疗效及不良反应的关系,为监测放疗对食管癌患者机体正常组织的损伤程度及细胞免疫功能的影响,探索更可靠的临床生物学量化指标。
     方法采用SCGE、MNT技术测定36例食管癌放疗患者不同放疗剂量时外周血淋巴细胞DNA损伤及不良反应情况。同时应用FCM检测患者不同放疗剂量时T淋巴细胞亚群的变化。
     结果①SCGE检测结果:正常对照组的外周血彗星拖尾率为18%,平均尾长为0.88±0.05;放疗前,患者组的外周血彗星拖尾率为22%,平均尾长为16.42±1.53;放疗剂量20Gy时,患者组的彗星拖尾率为44.6%,平均尾长为33.74±4.26;放疗剂量30Gy时,患者组的彗星拖尾率为50.5%,平均尾长为35.12±3.45;放疗剂量至40Gy时,患者组的彗星拖尾率为73.9%,平均尾长为41.83±2.36。②MNT检测结果:食管癌患者放疗前微核细胞率为0.31‰,放疗剂量20Gy时,微核细胞率为0.66‰;30 Gy时,微核细胞率为1.13‰;40Gy时,微核细胞率为2.31‰。③食管癌患者在确诊时,外周血T淋巴细胞亚群即存在细胞免疫功能的异常,表现为CD3~+和CD4~+以及CD4~+/CD8~+比例下降,而CD8~+变化不明显,而在接受放疗过程中,CD3~+和CD4~+以及CD4~+/CD8~+比例进一步下降。
     结论①不同放疗剂量对食管癌患者外周血淋巴细胞DNA确实存在损伤作用,且损伤程度不同。②放疗使食管癌患者机体的免疫功能较放疗前有不同程度的下降。③不同的放疗剂量可引起食管癌患者不同程度的不良反应。④本研究初步表明,食管癌患者外周血淋巴细胞DNA损伤及T淋巴细胞亚群监测,对食管癌放疗疗效评价有一定的参考意义,因此有必要做进一步的深入探讨。
Objective:By using the methods of SCGE(Single Cell Gel Electrophoresis),MNT (Micronucleus Test),and FCM(Flow Cytometry)respectively,DNA damage,adverse effects and variation situation of T lymphocyte subgroups in the peripheral lymphocyte of esophaus tumor sufferers after radiotherapy are measured;and the causality between radiotherapy dose and DNA damage degree to normal histiocyte are studied.The objective is to measure the DNA damage degree to normal histiocyte,the influence to immune ability of body of esophagus tumor sufferers after the radiotherapy.By means of this effect evaluation,more reliable quantitative change on clinical biology is studied.
     Methods:By using the methods of SCGE and MNT,DNA damage situation in the peripheral lymphocyte of 36 cases in different radiotherapy stages are measured. Meanwhile,by using the method of FCM,variation situation of the T lymphocyte groups of them in different stages are measured.
     Results:1.As to the SCGE measurement,the rate of length migration of the peripheral lymphocyte in healthy groups was 18%,averaged tail length was 0.88±0.05;the rate of length migration in patient groups before radiotherapy was 22%,averaged tail length was16.42±1.53;when the radiation dose was 20Gy,the rate of length migration was 44.6 %,averaged tail length was33.74±4.26;when radiation dose amounted to 30 Gy,the rate of length migration was 50.5%,averaged tail length was35.12±3.45;when radiation dose reached to 40 Gy,the rate of length migration was73.9%,averaged tail length was 41.83±2.36.2.As to the MNT measurement,the micronucleus cell rate of this sample was 0.66‰before the radiotherapy,and was 1.81‰before the radiotherapy.3.As to the immune function measurement,when they are diagnosed the esophagus tumor sufferers, their immune function of T lymphocyte subgroups were a little abnormal,that was,the proportion of the CD3~+,CD4~+,andCD4~+/CD8~+ was decreased while the CD8~+ was normal;but during the radiotherapy the proportion of the CD3~+,CD4~+and CD4~+/CD8~+ was decreased more.
     Conclusion:1.The different radiation dose can lead to the DNA damage of in the peripheral lymphocyte of the esophagus tumor patients;and the damaging degree varies according to difference of dose.2.Radiotherapy can reduce their immune function of the esophagus tumor sufferers in different degree.3.Different radiation dose may result in adverse effects in different degree.4.This study showed that the measurement to DNA damage of in the peripheral lymphocyte of the esophagus tumor sufferers,as well as that to T lymphocyte subgroups can provide some references on effect evaluation of radiotherapy to esophagus tumor.Therefore,more deeper discussion is necessary.
引文
[1]李连弟,鲁凤珠,张思维,等.中国恶性肿瘤死亡率20年变化趋势和近期预测分析[J].中国肿瘤,1997,19(1):3-4.
    [2]李广太.妇科肿瘤患者外周血淋巴细胞亚群研究[J].中国肿瘤临床,1996,23(7):505-506.
    [3]陈亦乐,唐迪红,陈民.宫颈癌患者外周血T淋巴细胞亚群的检测[J].中国现代医学杂志,1997,7(6):27-29.
    [4]汤钊猷主编.上海:上海医科大学出版社:现代肿瘤学[M].2000年第二版,658-691.
    [5]张天泽,徐光炜主编.天津:天津科学技术出版社:肿瘤学[M].1998年第一版,1244-1246.
    [6]申文江,王绿化主编.北京:中国医药科技出版社:放射治疗损伤[M].2001年第一版,115-119.
    [7]Ostling O,Johanson KJ.Microelectrophoretic study of radiation induced DNA damages in individual mamalian cells[J].Biochem Biophys Res Commun,1984,123:291-298.
    [8]洪承皎,张军宁.单细胞凝胶电泳在放射医学中的应用[J].国外医学.放射医学核医学分册,2000,24(6):281-284.
    [9]Singh NP,Mccoy MT,Tice RR,et al.A simple technique of quantization of low level of DNA damage in individual cells[J].Exp Cell Res,1988,175:184.
    [10]Olive PL,Durand RE,Jackson SM,et al.The comet assay in clinical practice[J].Acta Oncol,1999,38(2):839-844.
    [11]阎洁,杨伟志.“彗星”分析法及应用[J].中华放射肿瘤杂志,2002,11(1):66-68.
    [12]张玉晶,阎洁,高远红,等.中性彗星分析法检测肿瘤细胞的放射敏感性[J].中国肿瘤,2004,13(11):731-733.
    [13]Popanda O,Ebbeler R,Twardella D,et aI.Radiation-induced DNA damage and repair in lymphocytes from breast cancer patients and their correlation with acute skin reaction to radiotherapy[J].Int J Radiat Oncol Biol Phys,2003,55:1216-1225.
    [14]Dorie U,Schulte S,Stopper H,et al.DNA damage measured by the comet assay in head and neck cancer patients treated with tirapazamine[J].Neoplassia,1999,1:461-467.
    [15]Popanda O,Ebbeler R,Twardella D,et al.Radiation induced DNA damage and repair in lymphocytes from breast cancer patients and their correlation with acute skin reactions to radiotherapy[J].Int J Radiat Oncol Biol Phys,2003,55:1216-1225.
    [16]Popanda O,Schulte S,Stopper H,et al.In vitro radiosensitivity measured in lymphocytes and fibroblasts by colony formation and comet assay[J].Int J Radiat Biol,2002,78:611-616.
    [17]吕长兴,杨伟志,殷蔚伯,等.“彗星”法分析人肿瘤细胞DNA放射损伤和修复[J].中华放射肿瘤学杂志,2000,9:114-117.
    [18]李国文,孙文欣,师国珍,等.CB微核法在辐射效应检测中的应用[J].河南肿瘤学杂志.1998年,11:84-85.
    [19]Presser JS,Kallin D,Alexander JC,et al.Radiation induction of micronucleus in human lymphocyles[J].Mutat Res,1988,199:37-40.
    [20]王捷,何玲,郎锦义,等.外周血淋巴细胞微核变化值与鼻咽癌颈淋巴结转移灶放射敏感度的关系[J].癌症,1997,16(2):137-138.
    [21]陈慰峰主编.北京:人民卫生出版社:医学免疫学[M].2002年第三版,89-97.
    [22]金伯泉主编.西安:第四军医大学出版社:细胞分子免疫学实验技术[M].2003,78-81.
    [23]Ron E.Ionizing radiation and cancer risk evidence from epidemiology[J].Radiate Res,1998,150(suppl):530-533.
    [24]李莉,杨建一,杜圣家,等.低剂量甲氨蝶呤对DNA损伤的研究[J].卫生毒理学杂志,2004,18(2):96-97。
    [25]张遵真,衡正昌.用单细胞凝胶电泳技术检测铬和砷化合物的DNA损伤作用[J].中华预防医学杂志,1997,31:365-366.
    [26]殷蔚伯、谷铣之主编.北京:中国协和医科大学出版社:肿瘤放射治疗学[M].第三版,2002,2-3.
    [27]Boice JD,Engholm G,Kleeinerman RA,et al.Radiatioan dose and cancer risk in patients treated for cancer of the cerrix[J].Radiate Res,1988,116:3-8.
    [28]Boice JD.Carcinogenesis-a synopsis of human experience with external exposure in medicine[J].Health Phys,1988,55:621-626.
    [29]Olive PL,Wlodek D,Banath JP.DNA double strand breaks measure in individual cells subjiected to gel electrophoresis[J].Cancer Res,1991,51:4671-4677.
    [30]孙华明,陈国华.鼻咽癌放疗患者外周血淋巴细胞损伤及基因突变的研究[J].癌变·畸变·突变,2001,13(4):251-253.
    [31]韩萍,等.放疗对肿瘤患者外周血淋巴细胞DNA损伤的研究[J].中国综合临床.2002,11(2):45-46.
    [32]王捷,何玲,郎锦义,等.外周血淋巴细胞微核变化值与鼻咽癌颈淋巴结转移灶放射敏感度的关系[J].癌症,1997,16(3):137-138.
    [33]毛明华,黄世超,等.肿瘤患者放、化疗后外周血淋巴细胞损伤和免疫功能改变的研究[J].肿瘤,2004,24(6):589-591.
    [34]Monsieurs MA,Thierens HA,Vral A,et al.Patient dosimetry after MIBG therapy for neuroblastoma and carcinoid tumors[J].Nucl Med Commun,2001,22(4):367.
    [35]陆德源.上海:上海科学技术出版社:现代免疫学[M].1995,207-209.
    [36]陈东平,邵汛帆,魏永辉.食管癌患者放疗前后淋巴细胞亚群水平的观察[J].广州医药,1999,30(2):60-61.
    [37]裘宇容,曾方银,杨春莉.流式细胞仪对四种癌症病人T淋巴细胞亚群的检测[J].第一军医大学学报,1998,18(2):151-151.
    [38]刘文其.鼻咽癌患者放疗后细胞免疫功能的测定[J].广西医科大学学报,1998,15(1):48-50.
    [39]赵建强,王明臣,孙福廷,等.机体免疫水平的动态变化对肿瘤放疗效果的评价[J].潍坊医学院学报,1998,20(2):119-120.
    [40]梁业民,刘慧忠,刘翠芳,等.食道癌放疗前后外周血T细胞亚群的变化[J].四川肿瘤防治,1998,11(2):8-10.
    [41]Tisch I,Heimlich F,Daniel V,et al.Cellalar immune defect caused by postsurgical radiation tharaphy in patients with head and neck cancer[J].Otolaryngol Head Neck Surg,1998,119(4):412-413.
    [42]Fairbairn DW,Olive PL,ONeill KL.The comet assay:aucomprehensive review[J].Mutation Res,1993,288:47-53.
    [43]高建军,丰盛梅,金慰芳.碱性单细胞凝胶电泳铺胶技术的改进[J].复旦学报,2004,31(3):311-312.
    [1]王瑞芝.北京:人民卫生出版社:肿瘤放射治疗学[M],2005,4-61.
    [2].许昌韶.苏州:苏州大学出版社:肿瘤放射治疗学[M],2005,169-170.
    [3]Olive P,Vikse C,Durand R.Hypoxic fractions measured in murine tumors and normal tissues using the comet assay[J].Int J Radiat Oncol Biol Phys,1994,29(3):487.
    [4]Popanda O,Ebbeler R,Twardella D,et al.Radiation induced DNA damage and repair in lymphocytes from breast cancer patients and their correlation with acute skin reactions to radiotherapy[J].Int J Radiat Oncol Biol Phys,2003,55:1216-1225.
    [5]Oppitz U,Schulte S,Stopper H,et al.In vitro radiosensitivity measured in lymphocytes and fibroblasts by colony formation and comet assay[J].Int J Radiat Biol,2002,78:611-616.
    [6]Doric M,Kovacs M,Gabalski E,et al.DNA damage measured by the comet assay in head and neck cancer patients treated with tirapazamine[J].Neoplasia,1999,1:461-467.
    [7]Fairbairn D,Olive P,et al.The comet assay:A comprehensive review[J].Mutation Res,1995,339:37.
    [8]Huang P,Olive P,Durand R.Use of the comet assay for assessment of durg resistance and its modulation in vivo[J].Br J Cancer.1998,77:412-416.
    [9]Rydberg B,Jolanson K,Radiation-induced DNA strand breaks and their rejoining in crypt and villous cells of the small intestine of the mouse[J].Radiat Res.1975,64(2):281-292.
    [10]Olive P,Durand R,Jackson S,et al.The comet assay in clinical practice[J].Acta Oncol,1999,38:839-844.
    [11]Huang P,Olive P,Durand R.Use of the comet assay for assessment of durg resistance and its modulation in vivo[J].Br J Cancer.1998,77:412-416.
    [12]McLaren D,Pickles T,Thomson T,et al.Impact of nicotinamide on human tumor hypoxic fraction measured using the comet assay[J].Radiat Oncol,1997,45:175-182.
    [13]张军宁,洪承皎,朱寿彭.碱性单细胞凝胶电泳预测肿瘤细胞内在放射敏感性研究[J].国外医学肿瘤学分册,2003,21(2):228-229.
    [14]Colleu-Durel S,Guitton N,Nourgalieva K,et al.Genomic instability and breast cancer[J].Oncol Rep,2001,8(5):1001-1005.
    [15]Ostling K,Johanson.Microelectrophoretic study of radiation-induced DNA damages in individual mammalian cells[J].Biochem Biophys Res Commun,1984,123:291.
    [16]Leprat F,Alapetite C,Rosselli F,et al.Impaired DNA repair as assessed by the comet assay in patients with thyroid tumors after a history of radiation therapy:a preliminary study[J].Int J Radiat Oncol Boil Phys,1998,40:1019-1026.
    [17]Lankinen M,Vilpo L,Vilpo J.UA and gamma irradiation induced DNA single strand breaks and their repair in haman blood granulocytes and lymphocytes[J].Mutat Res,1996,5(1-2):31-38.
    [18]Marplos B,Longhurst D,Easthsm A,et al.The ratio of initial/residual DNA damage predicts intrinsic radiosensitivity in seven cervix carcinoma cell liners[J].Br J Cancer.1998,11(7):1108-1114.
    [19]李国文,孙文欣,师国珍,等.CB微核法在辐射效应检测中的应用[J].河南肿瘤学杂志.1998年,11:84-85.
    [20]Presser JS,Kallin D,Alexander JC,et al.Radiation induction of micronucleus in human lymphocytes[J].Murat Res,1988,199:37-40.
    [21]王捷,何玲,郎锦义,等.外周血淋巴细胞微核变化值与鼻咽癌颈淋巴结转移灶放射敏感度的关系[J].癌症,1997,16(3):137-138.
    [22]毛明华,黄世超,等.肿瘤患者放、化疗后外周血淋巴细胞损伤和免疫功能改变的研究[J].肿瘤,2004,24(6):589-591.
    [23]周睿,刘宏伟.口腔黏膜癌前病变脱落细胞微核计数的研究[J].中华口腔医学杂志,2001,36(2):127.
    [24]Monsieurs MA,Thierens HA,Vrat A,et al.Patient dosimetry after MIBG therapy for neuroblastoma and carcinoid tumors[J].Nucl Med Commun,2001,22(4):367.

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