Radiotherapy and Radiation Medicine, Banaras Hindu University, Institute of Medical Sciences, Varanasi, 221005, Uttar Pradesh, India.
Biochemistry, Banaras Hindu University, Institute of Medical Sciences, Varanasi, 221005, Uttar Pradesh, India.
Free Radic Biol Med. 2021 May 1;167:29-35. doi: 10.1016/j.freeradbiomed.2021.02.037. Epub 2021 Mar 9.
Oxidative stress and antioxidants are involved in all aspects of cervical cancer. The present study evaluated serum levels of oxidative stress and antioxidant biomarkers in cervical cancer patients and healthy controls. Moreover, the effect of Concurrent chemoradiotherapy (CCRT) on these biomarkers and their association with treatment outcome was investigated.
This study included ninety-seven cervical cancer patients and thirty controls. Three oxidative stress parameters (8-hydroxy-2-deoxyguanosine, Protein Carbonyl, and Malondialdehyde) and four antioxidant parameters (Superoxide Dismutase, Catalase, Glutathione Peroxidase, and Total Antioxidant Status) were measured. The analysis was conducted using repeated measures ANOVA for comparing among the phases (before, during, and follow-up) of treatment. The control group was compared using the Dunnet test. Logistic regression analysis was also conducted between oxidative stress and antioxidant parameters to study their association.
Significant rises in oxidative damage markers were observed in cervical cancer patients of all stages, compared to controls. There was a further increase in oxidative stress markers during CCRT among complete responders. However, among non-responders, the oxidative stress biomarkers like Protein Carbonyl and Malondialdehyde were unaltered during CCRT. Simultaneously, there was a significant decrease in antioxidant parameters in cervical cancer patients of all stages compared to controls. During CCRT, antioxidant levels continuously depleted among complete responders. Nevertheless, in non-responders, antioxidant parameters like Superoxide Dismutase and Total Antioxidant Status were consistent. The oxidative stress markers and antioxidant parameters normalized among complete responders at six months follow up. While in non-responders, the normalization of these parameters was not observed.
Our results indicate that increased oxidative stress and diminished antioxidants among patients were associated with carcinoma cervix. Induced oxidative stress and decreased antioxidant parameters during CCRT among the complete responders show the treatment's efficacy. Oxidant-antioxidant profile merits investigation as markers of diagnosis, treatment response, survival, and recurrence in extensive prospective studies.
氧化应激和抗氧化剂参与宫颈癌的各个方面。本研究评估了宫颈癌患者和健康对照者血清中氧化应激和抗氧化生物标志物的水平。此外，还研究了同期放化疗（CCRT）对这些生物标志物的影响及其与治疗结果的关系。
本研究纳入了 97 例宫颈癌患者和 30 例对照者。测量了 3 个氧化应激参数（8-羟基-2-脱氧鸟苷、蛋白羰基和丙二醛）和 4 个抗氧化参数（超氧化物歧化酶、过氧化氢酶、谷胱甘肽过氧化物酶和总抗氧化状态）。采用重复测量方差分析比较治疗各阶段（治疗前、治疗中、治疗后）之间的差异。对照组采用 Dunnett 检验进行比较。还对氧化应激和抗氧化参数之间进行了 logistic 回归分析，以研究它们之间的关系。
所有阶段的宫颈癌患者的氧化损伤标志物均显著升高，与对照组相比。在完全缓解者中，CCRT 期间氧化应激标志物进一步升高。然而，在无反应者中，CCRT 期间蛋白羰基和丙二醛等氧化应激标志物没有改变。同时，所有阶段的宫颈癌患者的抗氧化参数均显著低于对照组。在完全缓解者中，CCRT 期间抗氧化水平持续下降。然而，在无反应者中，超氧化物歧化酶和总抗氧化状态等抗氧化参数保持不变。在完全缓解者中，治疗 6 个月后氧化应激标志物和抗氧化参数恢复正常。而在无反应者中，这些参数没有恢复正常。
我们的结果表明，患者体内氧化应激增加和抗氧化剂减少与宫颈癌有关。完全缓解者中 CCRT 期间诱导的氧化应激和抗氧化参数减少表明治疗有效。在广泛的前瞻性研究中，氧化还原状态值得作为诊断、治疗反应、生存和复发的标志物进行研究。
