广西医学
廣西醫學
엄서의학
GUANGXI MEDICAL JOURNAL
2014年
2期
187-190
,共4页
周日晶%翁敬锦%司勇锋%韦海明%张政%兰桂萍%江河
週日晶%翁敬錦%司勇鋒%韋海明%張政%蘭桂萍%江河
주일정%옹경금%사용봉%위해명%장정%란계평%강하
鼻咽癌%重组人p53腺病毒注射液%同步放化疗%微血管密度%血小板
鼻嚥癌%重組人p53腺病毒註射液%同步放化療%微血管密度%血小闆
비인암%중조인p53선병독주사액%동보방화료%미혈관밀도%혈소판
Nasopharyngeal carcinoma%Recombinant human p 53 adenovirus%Concurrent chemo-radiotherapy%Microvessel density%Platelet
目的:观察放化疗联合重组人p53腺病毒注射液( rAd-p53)治疗鼻咽癌后对原发灶中CD34标记的微血管密度( CD34-MVD)及血小板( PLT)计数的影响,探讨其与预后的关系。方法63例中晚期鼻咽癌患者随机分为两组,基因组32例给予rAd-p53瘤内注射+同步放化疗;常规组31例仅给予同步放化疗。采用免疫组化二步法检测两组患者癌组织中CD34-MVD水平,并检测PLT。结果治疗后基因组鼻咽癌原发灶CD34-MVD明显低于治疗前( P<0.05),而常规组治疗前后CD34-MVD比较差异无统计学意义( P>0.05);治疗后两组PLT均显著下降(P均<0.05),并且基因组下降更明显(P<0.05)。随访3年,基因组和常规组局部复发、远处转移率比较差异无统计学意义( P>0.05);但CD34-MVD表达增加组远处转移率(38.5%)明显高于表达下降组(13.5%)(P<0.05),3年总生存率、无瘤生存率低于表达下降组(P<0.05);PLT增加组与PLT下降组的局部复发率、远处转移率、3年总生存率、无瘤生存率差异均无统计学意义(P均>0.05)。结论放化疗联合基因治疗中晚期鼻咽癌,可使CD34-MVD、PLT计数明显下降。 CD34-MVD过度表达可作为评估远处转移和预后不良的参考指标。
目的:觀察放化療聯閤重組人p53腺病毒註射液( rAd-p53)治療鼻嚥癌後對原髮竈中CD34標記的微血管密度( CD34-MVD)及血小闆( PLT)計數的影響,探討其與預後的關繫。方法63例中晚期鼻嚥癌患者隨機分為兩組,基因組32例給予rAd-p53瘤內註射+同步放化療;常規組31例僅給予同步放化療。採用免疫組化二步法檢測兩組患者癌組織中CD34-MVD水平,併檢測PLT。結果治療後基因組鼻嚥癌原髮竈CD34-MVD明顯低于治療前( P<0.05),而常規組治療前後CD34-MVD比較差異無統計學意義( P>0.05);治療後兩組PLT均顯著下降(P均<0.05),併且基因組下降更明顯(P<0.05)。隨訪3年,基因組和常規組跼部複髮、遠處轉移率比較差異無統計學意義( P>0.05);但CD34-MVD錶達增加組遠處轉移率(38.5%)明顯高于錶達下降組(13.5%)(P<0.05),3年總生存率、無瘤生存率低于錶達下降組(P<0.05);PLT增加組與PLT下降組的跼部複髮率、遠處轉移率、3年總生存率、無瘤生存率差異均無統計學意義(P均>0.05)。結論放化療聯閤基因治療中晚期鼻嚥癌,可使CD34-MVD、PLT計數明顯下降。 CD34-MVD過度錶達可作為評估遠處轉移和預後不良的參攷指標。
목적:관찰방화료연합중조인p53선병독주사액( rAd-p53)치료비인암후대원발조중CD34표기적미혈관밀도( CD34-MVD)급혈소판( PLT)계수적영향,탐토기여예후적관계。방법63례중만기비인암환자수궤분위량조,기인조32례급여rAd-p53류내주사+동보방화료;상규조31례부급여동보방화료。채용면역조화이보법검측량조환자암조직중CD34-MVD수평,병검측PLT。결과치료후기인조비인암원발조CD34-MVD명현저우치료전( P<0.05),이상규조치료전후CD34-MVD비교차이무통계학의의( P>0.05);치료후량조PLT균현저하강(P균<0.05),병차기인조하강경명현(P<0.05)。수방3년,기인조화상규조국부복발、원처전이솔비교차이무통계학의의( P>0.05);단CD34-MVD표체증가조원처전이솔(38.5%)명현고우표체하강조(13.5%)(P<0.05),3년총생존솔、무류생존솔저우표체하강조(P<0.05);PLT증가조여PLT하강조적국부복발솔、원처전이솔、3년총생존솔、무류생존솔차이균무통계학의의(P균>0.05)。결론방화료연합기인치료중만기비인암,가사CD34-MVD、PLT계수명현하강。 CD34-MVD과도표체가작위평고원처전이화예후불량적삼고지표。
Objective To observe the effect of chemo-radiotherapy combined with recombinant human p 53 adenovirus(rAd-p53) on microvessel density(MVD) determined by CD34 and platelet(PLT) count in patients with nasopharyngeal carcinoma ,and to investigate its relationship with the prognosis .Methods Sixty-three patients with advanced nasopharyngeal carcinoma were randomly divided into two groups , the gene group ( 32 cases ) recieved rAd-p53 intratumoral injection and concurrent chemo-radiotherapy , the control group ( 31 cases ) recieved concurrent chemo-radiotherapy .The two-step immunohistochemical method was used to detect MVD ,which was marked by CD 34 in the primary tumor tissues of nasopharyngeal carcinoma in two groups ,and PLT was also detected.Results CD34-MVD of primary tumor tissues of nasopharyngeal carcinoma after treatment was significantly lower than that before treatment in the gene group(P<0.05),there was no significant difference in CD34-MVD before and after treatment in the control group (P>0.05).PLT significantly decreased after treatment in the two groups (all P<0.05),and the decrease in the gene group was more significant(P<0.05).The follow-up lasted for three years,there was no significant difference in the local recurrence and distant metastasis rates between experimental group and control group ( P>0.05);The distant metastasis rate in the increasing CD34-MVD group was significantly higher than that in the decreasing CD34-MVD group (38.5% vs. 13.5%,P<0.05),the 3-year overall survival ,disease-free survival in the increasing CD34-MVD group was lower than those in the decreasing CD34-MVD group(P<0.05);There was no significant difference in the local recurrence and distant metastasis rates ,3-year overall survival ,disease-free survival between increasing PLT group and decreasing PLT group (P>0.05).Conclusion CD34-MVD and PLT count decrease significantly after chemo-radiotherapy plus p53 gene therapy performed in patients with nasopharyngeal carcinoma .The over-expression of CD34-MVD could be a predictor of distant metastasis and poor prognosis of nasopharyngeal carcinoma .