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目的 探讨常规分割放疗和超分割放疗对鼻咽癌组织细胞增殖凋亡的影响。方法 采用TdT酶介导的生物素化dutp缺口末端标记技术 (TUNEL)和免疫组织化学S P法 ,分别检测 6 0例鼻咽癌患者在放疗第 2周和第 4周时细胞凋亡率 (apop tosisrate ,AR)和增殖细胞核抗原 (proliferationcellnuclearantigen ,PCNA )的表达。 结果 常规分割放疗组放疗第 4周后的AR较放疗第 2周时下降 ,而PCNA增殖指数升高 (P <0 .0 1) ;加速超分割放疗组放疗第 2周和放疗第 4周的AR、PCNA增殖指数均无显著性差异 (P >0 .0 5 )。早期鼻咽癌 (Ⅰ、Ⅱ期 )放疗第 2周和放疗第 4周的AR、PCNA增殖指数亦无显著性差异 (P >0 .0 5 ) ;而晚期鼻咽癌 (Ⅲ、Ⅳ期 )放疗第 4周的PCNA增殖指数较放疗第 2周的高 ,AR却下降 (P <0 .0 1)。结论 鼻咽癌患者在常规分割放疗过程中存在肿瘤细胞加速再增殖和细胞凋亡率下降 ,而采用超分割放疗可以减少鼻咽癌细胞加速再增殖 ,提高凋亡率。
Objective To investigate the effects of conventional fractionated radiotherapy and hyperfraction radiotherapy on the proliferation and apoptosis of nasopharyngeal carcinoma cells. Methods TdT-mediated biotinylated dutp nick end labeling (TUNEL) and immunohistochemical SP methods were used to detect the apoptosis rate of 60 patients with nasopharyngeal carcinoma at the second and fourth week of radiotherapy (apop tosisrate, AR) and proliferating cell nuclear antigen (PCNA). Results In the conventional radiotherapy group, the AR of the 4th week after radiotherapy was lower than that of the 2nd radiotherapy, while the proliferation index of PCNA was increased (P <0.01); in the second radiotherapy group and the 4th radiotherapy group AR, PCNA proliferation index no significant difference (P> 0.05). There was no significant difference in the proliferating index of AR and PCNA between the second and the fourth week of radiotherapy for early stage nasopharyngeal carcinoma (stage Ⅰ and Ⅱ) (P> 0.05) PCNA proliferation index in the fourth week of radiotherapy was higher than that in the second week of radiotherapy, AR decreased (P <0.01). CONCLUSIONS: Nasopharyngeal carcinoma patients undergo accelerated re-proliferation of tumor cells and apoptosis rate during conventional fractionated radiotherapy. However, hyperfraction radiotherapy can reduce the accelerated proliferation and increase the apoptosis rate of nasopharyngeal carcinoma cells.