CAJ | 학술논문

目的探讨鼻咽癌组织中细胞自发凋亡及凋亡基因P53、bcl-2的表达在预测放射敏感性中的意义.方法对60例初治、无远处转移、放疗前鼻咽癌患者活检标本分别采用TUNEL法检测细胞自发凋亡,免疫组化技术检测P53和bcl-2基因的表达情况；临床观测患者放疗过程中鼻咽部肿瘤的消退情况.结果在鼻咽癌组织中突变型P53和bcI—2基因的表达水平呈正相关(r=0.642,P<0.05)；鼻咽癌组织中突变型P53基因表达水平与细胞自发凋亡率呈负相关(r=-0.865,P<0.05)；鼻咽癌组织中bcl-2基因表达水平与细胞自发凋亡率呈负相关(r=-0.675,P<0.05).突变型P53基因阳性表达水平与鼻咽癌瘤体的消退率呈负相关；bcl-2基因阳性表达水平与鼻咽癌瘤体的消退率呈负相关(放疗40Gy时,Rs=-0.751；放疗70Gy时,Rs=-0.820；P<0.05)；自发凋亡率与鼻咽癌瘤体的消退率呈显著正相关(放疗剂量为40Gy时,r=0.869；放疗剂量为70Gy时,r=0.918；P<0.01).患者的性别、年龄及分期与鼻咽癌瘤体的消退率均无相关性(P>0.05).结论本研究表明鼻咽癌中细胞自发凋亡率及凋亡相关基因P53、bcl-2的表达与即时疗效密切相关, P53、bcl-2基因之间可能存在协同作用；细胞自发凋亡率和P53、bcl-2蛋白可以作为鼻咽癌放射敏感性可能的预测指标,联合检测自发凋亡率和P53、bcl-2蛋白意义更大.
목적탐토비인암조직중세포자발조망급조망기인P53、bcl-2적표체재예측방사민감성중적의의.방법대60례초치、무원처전이、방료전비인암환자활검표본분별채용TUNEL법검측세포자발조망,면역조화기술검측P53화bcl-2기인적표체정황；림상관측환자방료과정중비인부종류적소퇴정황.결과재비인암조직중돌변형P53화bcI—2기인적표체수평정정상관(r=0.642,P<0.05)；비인암조직중돌변형P53기인표체수평여세포자발조망솔정부상관(r=-0.865,P<0.05)；비인암조직중bcl-2기인표체수평여세포자발조망솔정부상관(r=-0.675,P<0.05).돌변형P53기인양성표체수평여비인암류체적소퇴솔정부상관；bcl-2기인양성표체수평여비인암류체적소퇴솔정부상관(방료40Gy시,Rs=-0.751；방료70Gy시,Rs=-0.820；P<0.05)；자발조망솔여비인암류체적소퇴솔정현저정상관(방료제량위40Gy시,r=0.869；방료제량위70Gy시,r=0.918；P<0.01).환자적성별、년령급분기여비인암류체적소퇴솔균무상관성(P>0.05).결론본연구표명비인암중세포자발조망솔급조망상관기인P53、bcl-2적표체여즉시료효밀절상관, P53、bcl-2기인지간가능존재협동작용；세포자발조망솔화P53、bcl-2단백가이작위비인암방사민감성가능적예측지표,연합검측자발조망솔화P53、bcl-2단백의의경대.
Objective To investigate the correlation among the levels of the spontaneous apoptosis index ( SAI) , the expression of P53 and bcl-2,the radiosensitivity of nasopharyngeal carcinoma . Methods Sixty patients with nasopharyngeal carcinoma who received irradiation therapy alone without distant metas- tasis were registered in this study. Specimens were obtained before irradiation. The apoptotic index (AI) of each tissue specimen was evaluated by terminal deoxynucleotidy transferase mediated deoxyuridine triphophate nick-labling (TUNEL) assay and expressed as a percentage , Immunohisto-chemical evaluation for P53 and bcl-2, and the clinical response to radical radio- therapy in patients with nasopharyngeal carcinoma.( the clinical radiosensitivity of the tumor) was also performed. Results There was a positive correlation between the expression of mtp53 and bcl-2 genes in nasopharyngeal carcinoma; There was a significantly positive correlation between SAI and the rate of tumor regression.(40Gy,r =0. 869;70Gy,r =0.918;P<0.01). sex,age and clinic stage all showed no significant corre- lation with tumor extinction. Conclusion : This study indicates that there is a close rela- tionship among SAI ,expression of p53 and bcl-2,and the short term clinical response in patients with nasopharyngeal carci- noma ;the association with the radiosensitivity was highly significant .