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目的 探讨立体定向适形放疗对原发性肝癌的生物学效应。方法 对16例原发性肝癌病人中6例术前先行立体定向适形放射治疗，1月后再行手术切除，与同期仅行手术切除的另外10例病人进行对比分析，对手术标本进行细胞端粒酶活性检测及DNA电泳分析。结果 立体定向适形放射治疗对原发性肝癌组织有确实的杀伤效应，肿瘤细胞内已无端粒酶活性，DNA电泳显示肿瘤细胞的DNA链呈片状断裂的阶梯状图象。而未行立体定向放疗的10例病人肝癌组织中的端粒酶活性全部阳性，DNA电泳显示其连续完整。结论 立体定向适形放疗对原发性肝癌有强烈的杀伤效应，其机制为射线对肿瘤细胞的DNA造成损伤，并与其对端粒酶活性的抑制有关。
Objective To investigate the biological effects of stereotactic conformal radiotherapy on primary liver cancer. Methods Sixteen patients with primary hepatocellular carcinoma were treated with stereotactic radiotherapy before operation. One month later, they were surgically resected. Compared with 10 patients who underwent surgical resection only in the same period, Detection of telomerase activity and DNA electrophoresis analysis. Results Stereotactic conformal radiotherapy had a definite killing effect on primary hepatocellular carcinoma. There was no telomerase activity in the tumor cells. The DNA ladder of the tumor cells showed a ladder-shaped image with flaky rupture. However, none of the 10 patients who underwent stereotactic radiotherapy had all the positive telomerase activity in HCC tissues. DNA electrophoresis showed that the telomerase activity was continuous and complete. Conclusion Stereotactic conformal radiotherapy has a strong anti-tumor effect on primary hepatocellular carcinoma. The mechanism is that radiation damages the DNA of tumor cells and is related to the inhibition of telomerase activity.