Kubouchi T, Kimura K, Nakajima A, Katoh K, Eiraku H, Majima T, Wada T, Sumi T, Sakamoto N, Ebihara Y
Dept. of Surgery, Tokyo Medical College.
Gan To Kagaku Ryoho. 1994 May;21 Suppl 1:82-8.
We compared histological effects following radiotherapy in relation to the DNA ploidy pattern and the proliferating cell nuclear antigen (PCNA) positivity rate in 37 patients with rectal cancer who underwent preoperative radiation therapy. Twelve of 23 cases in which the PCNA positivity rate before irradiation was more than 25% showed the effectiveness of radiotherapy (52.2%), against 2 of 6 cases with a rate of less than 25%. Cases in which the rate was more than 25% tended to show more effectiveness. Seventeen of 23 cases in which the PCNA positivity rate was more than 25% showed a decrease in PCNA positivity rate (73.9%). The rate in 6 cases showed no change, and no cases had an increase. In particular, in 12 cases in which the PCNA positivity rate was more than 55%, half showed effectiveness, and the PCNA rate decreased 20% on average. The PCNA positivity rate tended to decrease as a result of irradiation, and especially in diploid cases there were significant differences in the rate before and after irradiation. We suggest that cases in which the PCNA positivity rate is more than 55% with diploid DNA pattern would show most effect. The effects of irradiation could be predicted with biopsy materials and by measuring the DNA ploidy pattern and the PCNA positivity rate.
我们比较了37例接受术前放疗的直肠癌患者放疗后的组织学效应与DNA倍体模式及增殖细胞核抗原(PCNA)阳性率之间的关系。在照射前PCNA阳性率超过25%的23例患者中,有12例显示放疗有效(52.2%),而在阳性率低于25%的6例患者中,只有2例有效。阳性率超过25%的病例往往显示出更高的有效性。在PCNA阳性率超过25%的23例患者中,有17例显示PCNA阳性率下降(73.9%)。6例患者的阳性率没有变化,也没有病例出现阳性率升高的情况。特别是在PCNA阳性率超过55%的12例患者中,一半显示有效,PCNA率平均下降了20%。照射后PCNA阳性率往往会下降,尤其是在二倍体病例中,照射前后的阳性率存在显著差异。我们认为,DNA模式为二倍体且PCNA阳性率超过55%的病例效果最为明显。通过活检材料以及测量DNA倍体模式和PCNA阳性率,可以预测放疗效果。