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目的探讨头颈部恶性肿瘤患者放疗前外周血淋巴细胞核内γ-H2AX焦点数与放疗后急性放射性黏膜和皮肤反应程度的相关性。方法选择2010年12月至2012年3月湖北三峡职业技术学院附属医院收治的34例头颈部恶性肿瘤初诊患者,采集其外周血进行1Gy的6MV-X线照射,通过细胞免疫荧光技术检测淋巴细胞核内γ-H2AX焦点数;同时追踪观察所有患者放疗后出现急性放射性黏膜和皮肤反应的情况,探寻其与外周血淋巴细胞核内γ-H2AX焦点数之间的相关性。结果 34例患者中,出现急性放射性黏膜反应Ⅰ级6例(占17.65%),Ⅱ级19例(占55.88%),Ⅲ级8例(占23.53%),Ⅳ级1例(占2.94%);出现急性放射性皮肤损伤Ⅰ级9例(占26.47%),Ⅱ级12例(占35.29%),Ⅲ级13例(占38.24%)。急性放射性黏膜和皮肤反应程度与患者外周血淋巴细胞核内γ-H2AX焦点数的水平均呈正相关(r=0.815,P<0.05;r=0.888,P<0.05)。结论头颈部恶性肿瘤患者放疗前检测外周血淋巴细胞核内γ-H2AX焦点数的水平可作为预测放疗后急性放射性黏膜和皮肤反应发生风险大小及严重程度的客观生物学指标。
Objective To investigate the correlation between γ-H2AX focal point in peripheral blood lymphocytes and the level of acute radiation mucosa and skin reaction after radiation therapy in patients with head and neck malignant tumor. Methods From December 2010 to March 2012, 34 cases of newly diagnosed head and neck cancer patients admitted to Affiliated Hospital of Three Gorges Vocational and Technical College in Hubei Province were collected. The peripheral blood was collected for 1 Gy of 6MV-X and the lymphocytes were detected by immunofluorescence The concentration of γ-H2AX in the nucleus of the nucleus was also observed. All the patients were followed up for acute radiation mucosa and skin reaction after radiotherapy and to find out the correlation between γ-H2AX focal point in peripheral blood lymphocytes. Results Among 34 patients, acute radiosensitization occurred in 6 cases (17.65%) of grade Ⅰ, 19 cases (55.88%) in grade Ⅱ, 8 cases (23.53%) in grade Ⅲ and 1 case (2.94%) in grade Ⅳ There were 9 cases (26.47%) of acute grade Ⅰ in grade Ⅰ, 12 cases in grade Ⅱ (35.29%) and 13 cases (38.24%) in grade Ⅲ. There was a positive correlation between acute radiation mucosa and skin reaction and the level of γ-H2AX focal point in peripheral blood lymphocytes (r = 0.815, P <0.05; r = 0.888, P <0.05). Conclusion The level of γ-H2AX focal point in peripheral blood lymphocytes before radiotherapy in patients with head and neck malignant tumor can be used as an objective biological index to predict the risk and severity of acute radiation mucosal and skin reactions after radiotherapy.