Höckel M, Schlenger K, Knoop C, Vaupel P
Department of Obstetrics and Gynecology, University of Mainz, Germany.
Cancer Res. 1991 Nov 15;51(22):6098-102.
Direct oxygen partial pressure (pO2) readings in cancers of the cervix and in the normal cervix of nulliparous or parous women were obtained using a computerized pO2 histography system. The oxygenation status of the tumors was evaluated as a function of clinical staging and histological grading. pO2 measurements were performed with a customized electrode system in conscious pre- and postmenopausal, untreated patients with well-defined arterial blood gas status. With this technique, pO2 measurements in the normal cervix of nulliparous women resulted in oxygenation patterns which were characteristic for normal, adequately supplied tissues (median pO2, 48 mm Hg) with approximately 1% of the pO2 values grouped between zero and 2.5 mm Hg, i.e., in a range with less than half-maximum radiosensitivity. As a rule, the mean (and median) pO2 values were distinctly lower in the normal cervix of parous women (most probably due to scar formation following vaginal delivery) and in malignancies. In the normal cervix of parous women the median pO2 value was 13 mm Hg (with approximately 14% of the pO2 readings in the lowest class), 14 mm Hg in International Federation of Gynecologists and Obstetricians I/II tumors (2% of the readings in the lowest pO2 class), and 11 mm Hg in International Federation of Gynecologists and Obstetricians III/IV cancers (1% of the pO2 data in the lowest class). To date, 5 of 18 cervical cancers exhibited pO2 values between zero and 2.5 mm Hg. The oxygenation pattern in cervical cancers and the occurrence of hypoxia and/or anoxia did not correlate with either the clinical stages and histological grades or with a series of clinically relevant parameters (e.g., tumor size). No significant differences were found between pre- and postmenopausal tumors, between squamous cell carcinomas and adenocarcinomas, and between endophytic or exophytic tumors. From these studies there is clear indication that the oxygenation status of individual tumors cannot be predicted on the basis of staging and/or grading, predominantly because of the pronounced tumor-to-tumor variabilities. Evaluation of the tissue oxygenation of individual tumors is thus mandatory to prove that tumor oxygenation can predict the overall prognosis and/or treatment outcome.
使用计算机化的氧分压（pO₂）组织成像系统，获取未生育或已生育女性宫颈癌及正常宫颈的直接氧分压（pO₂）读数。根据临床分期和组织学分级评估肿瘤的氧合状态。对绝经前和绝经后、未经治疗且动脉血气状态明确的清醒患者，使用定制电极系统进行pO₂测量。采用该技术，未生育女性正常宫颈的pO₂测量结果显示出正常、血供充足组织的典型氧合模式（中位pO₂为48 mmHg），约1%的pO₂值介于零至2.5 mmHg之间，即处于放射敏感性低于最大放射敏感性一半的范围内。通常，已生育女性正常宫颈以及恶性肿瘤中的平均（和中位）pO₂值明显较低（很可能是由于阴道分娩后形成瘢痕）。在已生育女性的正常宫颈中，中位pO₂值为13 mmHg（约14%的pO₂读数处于最低级别），国际妇产科联合会（FIGO）I/II期肿瘤为14 mmHg（2%的读数处于最低pO₂级别），FIGO III/IV期癌症为11 mmHg（1%的pO₂数据处于最低级别）。迄今为止，18例宫颈癌中有5例的pO₂值介于零至2.5 mmHg之间。宫颈癌的氧合模式以及缺氧和/或无氧的发生与临床分期、组织学分级或一系列临床相关参数（如肿瘤大小）均无关联。绝经前和绝经后肿瘤之间、鳞状细胞癌和腺癌之间以及内生性或外生性肿瘤之间均未发现显著差异。从这些研究中可以明确看出，无法根据分期和/或分级来预测个体肿瘤的氧合状态，主要原因是肿瘤之间存在显著差异。因此，必须评估个体肿瘤的组织氧合情况，以证明肿瘤氧合能够预测总体预后和/或治疗结果。
