| ObjectiveTo study the the damaged of nasal mucosa after radiotherapy(66~70Gy),observed and compared with the difference of restorability of damaged nasal mucosa in different time(including before radiotherapy,one month after radiotherapy,half year after radiotherapy),investigated how to prevent and reduce complication of radiotherapy,promote the nasal mucosa to recover and to regain mucociliary clearance.For this,improve patients'quality of life,provide foundation of therapy of complication of radiotherapy.Methods:1.Randomization are all biopsy in Dept of Otorhinolaryngology Head and Neck Surgery Andomization, final diagnosis is undifferentiated non-keratinizing nasopharyngeal carcinoma in pathology department of GuangDong People's Hospital between February 2008 and December 2009. Nuclear magnetic resonance scanning the nasopharyngeal basalis, neck to definite the range of tumour; sternite,B-type ultrasonography,bone scaning for whole body to clear out if there is distant metastasis; Staging is TNM of UICC(international union against cancer); Localition in radiotherapy department, faciocervical field for exposure field, irradiation dose is 66~ 70Gy. 2. Random sampling in three period:10 patients, before radiotherapy,7 males,3 females,21~61 years old, mean age 47.3, for control group;10 patients, one month after radiotherapy,7 males,3 females,34~70 years old, mean age 55.3; 10 patients, half a year after radiotherapy, mean age 45.1. All of the randomization have no chronic sinusitis,nasal polyp,allergic rhinitis,astrophic rhinitis in their medical history; never have any nasal cavity and nasal sinuses operations; have no Kartagener's syndrome. All of them add their signature on informed consent.3.Select mucosa of concha nasalis inferior for specimens, observed the mucosal histomorphology under light microscope and scanning electron microscope;To investigate the changes of activity of superoxide dismutase(SOD) and level of malondialdehyde(MDA).All the results were analyzed statistically.Results:1.Paraffin section(HE stain):before radiotherapy, most of the epithelial lamina is ciliated epithelium, array tidy and in order. There are glandula serosa, which is the major gland and slime gland in lamina propria, no analosis. One month after radiotherapy, ciliated epithelium were areosis and were damaged mostly. Basal lamina were thicken. All of the gland were analosis, especially for glandula serosa. Half a year after radiotherapy, although some of the construction of ciliated epithelium are recoverary, the arrange are still disorder, basal lamina were thicken. In spite of the number of glandula serosa are recoverary, the rate is low.2.Scanning electron microscope: before radiotherapy, most of the epithelial lamina is ciliated epithelium, array tidy and in order, the"9+2"construction of microblue is clear; One month after radiotherapy, ciliated epithelium were areosis and the cells were damaged mostly, the"9+2"construction of microblue is broken down.3. Half a year after radiotherapy, although some of the construction of ciliated epithelium are recoverary, the arrange are still disorder, the"9+2"construction of microblue is unclear.(1)The activity of SOD and level of MDA: The mean of activity of SOD before radiotherapy is 104.356±2.509u/mgprot;the mean of activity of SOD one month after radiotherapy is 60.790±2.928 u/mgprot; the mean of activity of SOD half a year after radiotherapy is 102.695±2.874 u/mgprot; the mean level of MDA before radiotherapy is 60.243±1.874nmol/mgprot;the mean level of MDA one month after radiotherapy is 86.051±2.551nmol/mgprot;the mean of MDA half a year after radiotherapy is 61.782±2.049nmol/mgprot.(2) The difference of activity of SOD between the group before radiotherapy and the group one month after radiotherapy was statistically significant(p=0.000<0.05),the difference of MDA level was statistically significant(p=0.000<0.05); The difference of activity of SOD between the group one month after radiotherapy and the group half a year after radiotherapy was statistically significant(p=0.000<0.05),the difference of MDA level was statistically significant(p=0.000<0.05); The difference of activity of SOD between the group before radiotherapy and the group half a year after radiotherapy was no statistically significant(p=0.676>0.05),the difference of MDA level was no statistically significant(p=0.621>0.05).Conclusion:1.One month after radiotherapy, the most serious of ionizing radiation damage is occurred .In the same period, the activity of SOD is decreased at the lowest level, the MDA content is at the highest level; half a year after radiotherapy, the mucosal repaired, but the arrange of ciliated epithelium are still disorder. In the same period, the activity of SOD was rise, the MDA content was decreased, all of the was no statistically significant. 2. Nasal mucosa and the ciliated epithelium morphology can be partially repaired,Local anti-oxidation function returned to the level of pre-radiation,but the ciliary beat function has not been fully restored to normal. |
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