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目的 探讨前列腺癌 (PC)治疗前体外照射诱导的Go淋巴细胞微核量是否与放疗 (xRT)相关疾病的发生有关。方法 对 3 8例PC周围血淋巴细胞 (PBL)以细胞因子阻止的微核法进行前瞻性观察。患者平均年龄 68.7± 1.0岁。临床分期 :T116例 ,T2 16例 ,T36例。治疗前前列腺癌特异性抗原 (PSA)≤ 4ng·ml-1者 5例 ,4～ 10ng·ml-1者 19例 ,>10ng·ml-1者 14例。所有患者均接受标准的骨盆外xRT(41.4～ 5 0 .4Gy) ,追加剂量 (16.4～ 2 6Gy)。平均随访 3 2 .8± 4.6个月。随访末 ,按RTOG标准对胃肠道 (GI)或泌尿生殖道 (GU)xRT相关疾病的发生率进行评定。结果 发生xRT相关疾病 2 4例为高敏 (HS) ,未发生者 14例为正常敏感性 (NS) ,HS患者均有GI(1～ 3级 )或GU(1～ 2级 )xRT相关疾病。体外照射暴露的血标本 ,与照射剂量相关的PBL微核量在HS和NS患者之间有显著差异 ,特别是当剂量≥ 3Gy时。xRT相关疾病的发生与治疗前PBL微核量相关 ,而与病情无关。结论 与xRT前体外照射剂量相关的PBL微核量是骨盆xRT的PC患者GI或GU疾病发生的一个预示因素
Objective To investigate if micronuclei of Go lymphocytes induced by extracorporeal radiation before prostate cancer (PC) treatment are related to the occurrence of xRT-related diseases. Methods 38 cases of PC peripheral blood lymphocytes (PBL) with cytokine blocking micronuclei were prospectively observed. The average age of patients was 68.7 ± 1.0 years. Clinical stage: T116 cases, T2 16 cases, T36 cases. There were 5 cases with PSA ≤ 4ng · ml-1, 19 cases with 4 ~ 10ng · ml-1 and 14 cases with> 10ng · ml-1 before treatment. All patients received standard pelvic xRT (41.4 to 54.0 Gy) and additional dose (16.4 to 26 Gy). The average follow-up was 32.2 ± 4.6 months. At the end of follow-up, the incidence of gastrointestinal (GI) or genitourinary tract (GU) xRT-related diseases was assessed by RTOG criteria. Results 24 cases of xRT-related diseases were hypersensitive (HS), 14 cases were nonsurvivors (NS), and patients with HS had grade 1 (grade 3) or GU (grade 1 ~ 2) xRT related diseases. Exposed to blood samples exposed to radiation, the amount of PBL micronuclei associated with the irradiation dose was significantly different between HS and NS patients, especially at doses ≥ 3Gy. The incidence of xRT-related diseases is related to the micronuclei of PBL before treatment, but not related to the condition. Conclusions PBL micronucleus levels associated with pretreatment dose of xRT are a predictor of GI or GU disease in PC patients with pelvic xRT