Ravi Kumar Satish, N B Pushpa, Kishore Sanjeev, Kaur Sohinder, Mehta Vandana, Krishnan Ajay S
Department of Anatomy, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Department of Anatomy, JSS Medical College, JSSAHER, Mysore, Karnataka, India.
J Family Med Prim Care. 2021 Dec;10(12):4548-4552. doi: 10.4103/jfmpc.jfmpc_948_21. Epub 2021 Dec 27.
Radiotherapy is commonly used in the treatment of oral and oropharyngeal carcinomas, either alone or in combination with other modalities of treatment like surgery/chemotherapy. It is always essential to know the nature of tumor response to the irradiation for successful outcomes and prognosis. With this view, the study has been conducted to document the usefulness of nuclear changes, karyolysis (KL), and karyorrhexis (KR) in particular as prognostic markers during the treatment.
Sixty patients, aged between 28 and 73 years (56 males and 4 females) years, histopathologically confirmed cases of oral and oropharyngeal carcinoma of different degrees of differentiation, were included in the study. The mode of treatment for the patients was radiotherapy with a radiation dose plan of 4 Gy, 14 Gy, 24 Gy, and 60 Gy on the 2, 7, 12, 30 days, respectively. The mucosal scrapings obtained from the site of the lesion at each interval were stained with Giemsa and May-Grunwald's stain. The stained slides were studied to assess the frequency of KL and KR.
It was observed that there was no significant difference between the site of lesion and tumor differentiation with the frequency of KL or KR. However, there was a statistically significant difference in the KL and KR indices with each interval of treatment. The percentage of relative increment among both the studied parameters was also significant, indicating their efficiency as a promising prognostic marker in radiotherapy.
Hence, assessment of KL and KR at different intervals of time during radiotherapy could be used as an efficient tool to determine the radiosensitivity and prognosis in oral and oropharyngeal carcinoma patients.
放射疗法常用于口腔和口咽癌的治疗，可单独使用，也可与手术/化疗等其他治疗方式联合使用。了解肿瘤对放疗的反应性质对于取得成功的治疗效果和预后至关重要。基于此观点，开展了本研究，以记录核变化，特别是核溶解（KL）和核碎裂（KR）作为治疗期间预后标志物的有用性。
本研究纳入了60例年龄在28至73岁之间（56例男性和4例女性）、经组织病理学确诊的不同分化程度的口腔和口咽癌病例。患者的治疗方式为放疗，放疗剂量计划分别为在第2、7、12、30天给予4 Gy、14 Gy、24 Gy和60 Gy。在每个时间间隔从病变部位获取的黏膜刮片用吉姆萨染色和迈-格鲁恩瓦尔德染色。对染色后的玻片进行研究，以评估KL和KR的频率。
观察发现，病变部位和肿瘤分化程度与KL或KR的频率之间无显著差异。然而，在每个治疗间隔的KL和KR指数存在统计学显著差异。两个研究参数的相对增量百分比也很显著，表明它们作为放疗中有前景的预后标志物的有效性。
因此，在放疗期间不同时间间隔评估KL和KR可作为确定口腔和口咽癌患者放射敏感性和预后的有效工具。
