Clinical and histopathological research on predictive evaluation of the effect of radiotherapy combined with or without chemotherapy for lung cancer

本研究采用端粒重复扩增技术和逆转录- pcr技术，分别分析了62例肺癌患者的癌性和非癌性肺组织中端粒酶活性和在端粒酶激活中起关键作用的hTERT基因mRNA （hTERT）的表达水平。各组组织标本端粒酶表达水平与临床病理指标进行比较。在癌组织中检测到端粒酶活性和hTERT（分别为75.8和75.8%），而在非癌组织中未观察到这些参数。在端粒酶表达的定量评估中，端粒酶活性和hTERT与淋巴结转移有显著相关性（NO vs. N+， P<0.05）。端粒酶活性与肿瘤细胞分化及分期相关（P<0.05），但与其他临床病理指标无相关性。hTERT阳性肿瘤患者的无病生存期明显短于hTERT阴性肿瘤患者（P=0.0334）。由于hTERT水平与代表患者疾病真实侵袭性的N因子在临床预后评价中的相关性，hTERT被发现是揭示肺癌生物学恶性潜能的重要标志物之一。为了减少正常组织损伤，我们采用三维（3D）适形单次高剂量增强放射手术（SRS），利用我们的螺旋分析仪呼吸门控系统治疗外周T1期非小细胞肺癌（NSCLC）。24例患者接受标准剂量30 GY/10或40 GY/ 20，并使用3D非共面SRS单次高剂量20 GY的强化治疗。20个肿瘤（83%）显示局部反应。除了一名患者有2级肺炎外，没有放射性肺炎高于国家癌症研究所-常见毒性标准1级。使用我们的呼吸门控系统的三维适形单次高剂量增强SRS治疗外周TI非小细胞肺癌是有用的。少

In the present study, quantitative levels of telomerase activity and hTERT gene mRNA (hTERT) expression playing a key role in telomerase activation were analyzed in cancerous and non-cancerous lung tissues of 62 lung cancer patients by telomeric repeat amplification protocol and reverse transcription-PCR, respectively. The telomerase expression levels of each group of tissue samples were compared with clinicopathologic variables. Telomerase activity and hTERT were detected in cancerous tissues (75.8 and 75.8%, respectively), while these parameters were not observed in any non-cancerous tissues. In quantitative assessment of telomerase expression, both telomerase activity and hTERT were significantly correlated with lymph node metastasis (NO vs. N+, P<0.05). Telomerase activity also correlated with tumor cell differentiation and stage classification (P<0.05), but did not correlate with other clinicopathologic variables. The disease-free survival in patients with lung cancer demonstrated … More that patients with hTERT-positive tumor survived for a significantly shorter period than those with hTERT negative tumor (P=0.0334). Since hTERT levels are correlated with N factor which represents the true aggressiveness of patients' disease concerning the evaluation of clinical outcome, hTERT was found to be one of the important markers revealing biological malignant potentials for lung cancer. To reduce the normal tissue damag, we adopted three-dimensional (3D) conformal single high-dose boost radiosurgery (SRS) by using our spiro-analyzer respiratory gating system for peripheral T1 non-small cell lung cancer (NSCLC). Twenty-four palients were treated with a standard fractionation of 30 GY/10 fractions or 40 Gy/20 fractions and a single high-dose boost of 20 Gy using 3D non-coplanar SRS. Twenty tumors (83%) showed a local responce. No radiation pneumonitis greater than National Cancer Institute-Common Toxicity Criteria Grade 1 was noted except one patient had grade 2 pneumonitis. 3D conformal single high-dose boost SRS using our respiratory gating system was useful for the treatment of peripheral TI NSCLC. Less