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[目的]探讨“彗星”分析法应用于预测临床鼻咽癌放射敏感性的可能性。[方法]60例鼻咽癌纳入本研究,其中男性43例,女性17例,中位年龄47岁;应用“彗星”分析法检测鼻咽癌患者放疗前鼻咽活检组织的放射敏感性,用尾力矩之比(RTM)表示;所有病例在放疗前以及在放疗中(中位剂量50Gy)复查螺旋CT或MR,分别测量肿瘤最大横截面积S0和S50,临床放射敏感性用肿瘤最大横截面积的消退率(Rs)表示;根据Rs将临床放射敏感性分为低度敏感(Rs≤50%)、中度敏感(50%-75%)和高度敏感(Rs>75%)。[结果]全组患者RTM与Rs呈显著正相关(Pearson相关系数0.410,P=0.001),在Ⅱ、Ⅲ和Ⅳ期每一组患者中,RTM与Rs也均有显著相关性(P<0.05)。线性回归分析显示RTM能对Rs做出较准确的估计(F=13.271,P=0.001),回归系数B=0.502(95%CI:0.380～0.624,t=8.276,P= 0.000)。在高、中、低度临床放射敏感性的三组患者中,其RTM平均值分别为4.51(4.51±0.55)、3.48(3.48±0.42)和2.14 (2.14±0.32),具有显著性统计学意义(F=7.859,P=0.001)。[结论]初步研究表明,“彗星”分析法检测的鼻咽癌肿瘤细胞RTM,与个体肿瘤患者的临床放射敏感性存在显著的相关性,RTM能对鼻咽癌的临床放射敏感性做出较准确的估计,具有一定的临床应用潜力
[Objective] The purpose of this study was to investigate the possibility of “comet assay” in predicting radiosensitivity of clinical nasopharyngeal carcinoma. [Methods] Sixty NPC patients were enrolled in this study, including 43 males and 17 females, with a median age of 47 years. Nasopharyngeal biopsies of patients with nasopharyngeal carcinoma before radiotherapy were assayed for radiosensitivity using “Comet” analysis (RTM). All cases were retrospectively analyzed by spiral CT or MR before radiotherapy and during radiotherapy (median dose 50 Gy), and the maximum tumor cross-sectional area S0 and S50 were measured respectively. The maximum radiotherapy sensitivity According to Rs, clinical radiosensitivity was divided into low sensitivity (Rs≤50%), moderate sensitivity (50% -75%) and highly sensitivity (Rs> 75%). [Results] There was a significant positive correlation between RTM and Rs in all patients (Pearson correlation coefficient 0.410, P = 0.001). There was also a significant correlation between RTM and Rs in all patients in stages II, III and IV (P <0.05 ). Linear regression analysis showed that RTM could make a more accurate estimate of Rs (F = 13.271, P = 0.001) and regression coefficient B = 0.502 (95% CI: 0.380-0.624, t = 8.276, P = 0.000). Among the three groups of patients with high, medium and low clinical radiosensitivity, the average RTM was 4.51 (4.51 ± 0.55), 3.48 (3.48 ± 0.42) and 2.14 (2.14 ± 0.32), respectively, with significant statistical significance (F = 7.859, P = 0.001). [Conclusion] Preliminary studies have shown that there is a significant correlation between the RTM of NPC tumor cells and the clinical radiosensitivity of individual tumor patients detected by the “Comet” assay. RTM can be used to evaluate the clinical radiosensitivity of nasopharyngeal carcinoma A more accurate estimate, with a certain clinical potential