Hänsgen G, Hintner I, Krause V, Wohlrab W, Dunst J
Klinik für Strahlentherapie, Martin-Luther-Universität Halle-Wittenberg.
Strahlenther Onkol. 1997 Jul;173(7):385-7. doi: 10.1007/BF03038242.
Investigation whether tumor tissue oxygenation is influenced by proliferation or p53-status in cervical cancers.
From April 1995 through December 1996, 28 patients with locally advanced cervical cancers (age 36 to 78 years; FIGO stages: 10 patients IIB, 16 patients IIIB, 2 patients IVA) underwent intratumoral measurement of pO2 prior to definitive radiotherapy. The histological specimens were examined for grading and quantitative immunohistological expression of the MIB-antigen and p53-protein. Proliferation was estimated by measuring the S-phase fraction with flow cytometry.
The median pO2-values showed a broad variation from 2.2 through 60.4 mm Hg, median 19.7 mm Hg. The S-phase fraction varied from 4.2 through 34.2% (median 11.6%), MIB-positive cells from 20 through 100% (median 74%), and immunohistologically p53-positive cells from 0 through 95% (median 2%). The patients were divided in 2 groups according to the pretreatment pO2. Tumors with a pO2 above the median had a lower S-phase fraction than tumors with a pO2 below the median, 10.4 +/- 3.8% versus 16.3 +/- 5.5%, p < 0.02. MIB and p53 were not different in both groups (MIB: 68.1 +/- 27.7% versus 75.0 +/- 18.4%, p = 0.1; p53: 26.4 +/- 38.5% versus 18.1 +/- 19.8%, n. s.). Grade of differentiation and FIGO stage had no impact on pO2.
Locally advanced cervical cancers with a poor oxygenation have a higher proliferative activity. Tumor proliferation may play a causative role for the development of hypoxia as suspected from radiobiological theories.
研究宫颈癌肿瘤组织氧合是否受增殖或p53状态的影响。
1995年4月至1996年12月,28例局部晚期宫颈癌患者(年龄36至78岁;国际妇产科联盟(FIGO)分期:10例IIB期,16例IIIB期,2例IVA期)在确定性放疗前进行瘤内氧分压(pO2)测量。对组织学标本进行MIB抗原和p53蛋白的分级及定量免疫组织化学表达检查。通过流式细胞术测量S期分数来估计增殖情况。
pO2中位数显示出广泛变化,从2.2至60.4毫米汞柱,中位数为19.7毫米汞柱。S期分数从4.2%至34.2%(中位数11.6%),MIB阳性细胞从20%至100%(中位数74%),免疫组织化学p53阳性细胞从0至95%(中位数2%)。根据放疗前pO2将患者分为两组。pO2高于中位数的肿瘤S期分数低于pO2低于中位数的肿瘤,分别为10.4±3.8%和16.3±5.5%,p<0.02。两组的MIB和p53无差异(MIB:68.1±27.7%对75.0±18.4%,p=0.1;p53:26.4±38.5%对18.1±19.8%,无显著性差异)。分化程度和FIGO分期对pO2无影响。
氧合差的局部晚期宫颈癌具有较高的增殖活性。如放射生物学理论所推测,肿瘤增殖可能在缺氧发展中起致病作用。