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1.

Aim

The aim of the study was to verify the dose distribution optimisation method in pulsed brachytherapy.

Background

The pulsed-dose rate brachytherapy is a very important method of breast tumour treatment using a standard brachytheraphy equipment. The appropriate dose distribution round an implant is an important issue in treatment planning. Advanced computer systems of treatment planning are equipped with algorithms optimising dose distribution.

Materials and methods

The wax-paraffin phantom was constructed and seven applicators were placed within it. Two treatment plans (non-optimised, optimised) were prepared. The reference points were located at a distance of 5 mm from the applicators’ axis. Thermoluminescent detectors were placed in the phantom at suitable 35 chosen reference points.

Results

The dosimetry verification was carried out in 35 reference points for the plans before and after optimisation. Percentage difference for the plan without optimisation ranged from −8.5% to 1.4% and after optimisation from −8.3% to 0.01%. In 16 reference points, the calculated percentage difference was negative (from −8.5% to 1.3% for the plan without optimisation and from −8.3% to 0.8% for the optimised plan). In the remaining 19 points percentage difference was from 9.1% to 1.4% for the plan without optimisation and from 7.5% to 0.01% for the optimised plan.No statistically significant differences were found between calculated doses and doses measured at reference points in both dose distribution non-optimised treatment plans and optimised treatment plans.

Conclusions

No statistically significant differences were found in dose values at reference points between doses calculated by the treatment planning system and those measured by TLDs. This proves the consistency between the measurements and the calculations.  相似文献   

2.
BackgroundThe purpose of this study was to evaluate and compare results obtained in high dose rate (HDR) brachytherapy treatment of vaginal cancer. Different catheters distributions inside the custom mold were explored. The difference between those distributions is the position of the posterior catheter located near the rectum in the actual custom mold applicator used in different hospitals, each one having a catheter displacement of 0.5 which is equal to the length of a step position. The best catheters distribution offering an optimal dose distribution: better coverage of the clinical target volume (CTV), while reducing the dose received by organs at risk (OARs), were discussed.Materials and methodsA group of 60 patients treated with HDR brachytherapy, alone or in combination with external radiotherapy, was investigated. A custom mold is normally used for HDR brachytherapy vaginal cancer treatment. Three different geometrical positions of the catheters (G1, G2 and G3) and, consequently, 3 different dosimetries were simulated out for each patient on the CT images, using the Oncentra planning system. The coverage of the CTV was studied.ResultsThe average volume treated was 30.46 cc (min = 9.8 cc, max = 70.86 cc). The total prescribed dose, including external and internal radiotherapy, was 80 Gy. We evaluated conformity index (CI), dose homogeneity index (DHI) and conformality index (COIN) indices for the three implantation geometries to reach the same coverage criteria of the CTV. The D2cc parameter allowed the evaluation of the dose received by the OARs. For the rectum, a dose reduction of 9.67% (range 0.29–32.86) was obtained with the second geometry of implantation compared to 10.14% (range 1.43–28.33) with the third geometry. For the bladder, the second geometry of implantation showed a better preservation for this organ [15.93% (range 0.86–58.71) vs. 8.35% (range 0.33–30.43) with the third geometry]. The sigmoid was more protected using the second plan of implantation as well [6.33% (range 0.14–40.71) for the second implantation compared to 5.95% (range 0.33–36) for the third implantation].ConclusionsG2 and G3 catheters’ distribution, having catheter position farther from the mold wall and so from the vaginal wall compared to the catheter position applied showed a better protection for the OARs while giving the same prescribed dose for the CTV.  相似文献   

3.
4.

Aim

To calibrate Ir-192 high dose rate (HDR) brachytherapy source using different calibration methods and to determine the accuracy and suitability of each method for routine calibrations.

Background

The source calibration is an essential part of the quality assurance programme for dosimetry of brachytherapy sources. The clinical use of brachytherapy source requires an independent measurement of the air kerma strength according to the recommendations of medical physics societies.

Materials and methods

The Ir-192 HDR brachytherapy source from Gammamed plus machine (Varian Medical Systems, Palo Alto, CA) was calibrated using three different procedures, one using the well-type ionization chamber, second by the in-air calibration method and third using solid water phantoms. The reference air kerma rate (RAKR) of the source was determined using Deutsche Gesellschaft fur Medizinische Physik (DGMP) recommendations.

Results

The RAKR determined using different calibration methods are in good agreement with the manufacturer stated value. The mean percentage variations of 0.21, −0.94, −0.62 and 0.58 in RAKR values with respect to the manufacturer quoted values were observed with the well-type chamber, in-air calibration, cylindrical phantom and slab phantom measurements, respectively.

Conclusion

Measurements with a well-type chamber are relatively simple to perform. For in-air measurements, the indigenously designed calibration jig provides an accurate positioning of the source and chamber with minimum scatter contribution. The slab phantom system has an advantage that no additional phantom and chamber are required other than those used for external beam therapy dosimetry. All the methods of calibration discussed in this study are effective to be used for routine calibration purposes.  相似文献   

5.
Malignant tumors have high metabolic and perfusion rates, which result in a unique temperature distribution as compared to healthy tissues. Here, we sought to characterize the thermal response of the cervix following brachytherapy in women with advanced cervical carcinoma. Six patients underwent imaging with a thermal camera before a brachytherapy treatment session and after a 7-day follow-up period. A designated algorithm was used to calculate and store the texture parameters of the examined tissues across all time points. We used supervised machine learning classification methods (K Nearest Neighbors and Support Vector Machine) and unsupervised machine learning classification (K-means). Our algorithms demonstrated a 100% detection rate for physiological changes in cervical tumors before and after brachytherapy. Thus, we showed that thermal imaging combined with advanced feature extraction could potentially be used to detect tissue-specific changes in the cervix in response to local brachytherapy for cervical cancer.  相似文献   

6.
BackgroundRecommendations for adjuvant treatment for postoperative, early-stage endometrial cancer varies from observation through vaginal brachytherapy alone to pelvic radiation. While observation alone can lead to recurrence, external radiotherapy has increased morbidity. The aim of this study is to show our results with vaginal brachytherapy alone using a multichannel applicator for treatment of early-stage endometrial cancer.Materials and methodsConsecutive patients undergoing vaginal brachytherapy alone following surgery for early-stage endometrial cancer were examined. A Miami multichannel vaginal brachytherapy applicator was used to deliver HDR brachytherapy in 62 patients from May 2013 to June 2018. CT scan-based images guided planning. A dose of 5.5–6.5 Gy × 4 fractions was prescribed 5 mm from the surface of the applicator.ResultsAt a median follow up of 19 months (6–48 months), 93% of patients treated were alive with no recurrence. Two patients had only local recurrence, and 1 was salvaged with external radiotherapy and chemotherapy. There was only one nodal failure and 2 distant failures. There was no grade 2 or higher vaginal, gastrointestinal or genitourinary toxicity.ConclusionVaginal brachytherapy alone using a multichannel applicator can be considered for early-stage endometrial cancers without compromising outcomes.  相似文献   

7.
PurposeRetrospective, single-institution analysis of clinical outcomes and treatment-related toxicity in patients treated with salvage I-125 low-dose rate (LDR) brachytherapy (BT) for locally-recurrent prostate cancer after radiotherapy.Materials and methodsBetween 2008 and 2018, 30 patients with biopsy-confirmed prostate cancer recurrence underwent salvage treatment with I-125 LDR-BT. Of these 30 patients, 14 were previously treated with primary external beam radiotherapy (EBRT; median dose, 73 Gy) and 16 with primary I-125 LDR-BT (145 Gy and 160 Gy in 14 and 2 cases, respectively). At seed implantation, the mean age was 75.8 years, with a median Gleason score of 7 and pre-salvage PSA of <10 ng/mL. Six patients received androgen deprivation therapy for six months after relapse diagnosis. The prescribed salvage I-125 BT dose to the gland was 120−130 Gy, with dose restrictions of Dmax <135% (urethra) and <100% (rectum). Toxicity was evaluated according to the CTCAE scale (v4.0).ResultsAt a median follow-up of 45 months, the biochemical recurrence-free survival rates at 1, 3 and 5 years were 86.7%, 56.7% and 53.3%, respectively. Overall survival at 5 years was 87%. On the multivariate analysis, two variables were significant predictors of recurrence: PSA at relapse and nadir PSA post-salvage. Grade 3 genitourinary toxicity was observed in 5 patients (radiation-induced cystitis in 3 cases and urethral stenosis in 2) and G3 gastrointestinal toxicity in 3 patients (rectal bleeding).ConclusionSalvage therapy with I-125 brachytherapy is a safe and effective treatment option for locally-recurrent prostate cancer in previously-irradiated patients. High pre-salvage PSA and post-salvage nadir PSA values were significantly associated with a worse disease control after salvage I-125 LDR-BT. In well-selected patients, I-125 LDR-BT is comparable to other salvage therapies in terms of disease control and toxicity. However, more research is needed to determine the optimal management of locally-recurrent prostate cancer.  相似文献   

8.

Background

Prostate cancer is an illness with a high incidence, especially among older men. The choice of a treatment option among men above 75 years is, however, not clear. Radical prostatectomy in this age group is connected with a relatively high morbidity. A further possibility of curative treatment is radiotherapy which can be administered in the form of external beam or in combination with high dose rate (HDR) brachytherapy.

Aim

The aim of our work was to evaluate how HDR brachytherapy is tolerated among men older than 75 and how associated diseases can influence the tolerance to this treatment. Of interest to us were the treatment results and mortality from other diseases.

Materials and methods

We analyzed a sample of 20 men above 75 years old (median 77 years) who were undergoing treatment by a combination of external radiotherapy and brachytherapy. Sixteen (80%) of them had prostate cancer with an intermediate and high risk of recurrence, four had low risk prostate cancer. Most patients, 14 (70%), had less than two comorbidities.

Results

The median observation period was 57 months. No perioperative complications were recorded. Acute genitourinary toxicity (GU) to a maximum grade of 1–2 manifested in 60% of cases. Acute gastrointestinal toxicity (GIT) was observed only at grade 1 and in 25% of cases. Late GU toxicity occurred in 35% of patients, with only one showing grade 3; late GIT toxicity was recorded at grade 1 only in 3 patients (15%). 70% of the men lived longer than 3 years after treatment, at present, 50% lived more than 5 years. Long-term biochemical remission was achieved in 18 patients (90%).

Conclusions

HDR BRT is possible and well-tolerated in older men above 75 years in good condition and without serious intercurrence.Well-selected older patients with higher-risk tumours and without serious comorbidities undoubtedly benefit from radical treatment when compared with watchful waiting.  相似文献   

9.
Cobalt-60 (Co-60) is a relatively new source for the application of high-dose rate (HDR) brachytherapy. Radiation dose to the rectum is often a limiting factor in achieving the full prescribed dose to the target during brachytherapy of cervical cancer. The aim of this study was to measure radiation doses to the rectum in-vivo during HDR Co-60 brachytherapy. A total of eleven HDR brachytherapy treatments of cervical cancer were recruited in this study. A series of diodes incorporated in a rectal probe was inserted into the patient's rectum during each brachytherapy procedure. Real-time measured rectal doses were compared to calculated doses by the treatment planning system (TPS). The differences between calculated and measured dose ranged from 8.5% to 41.2%. This corresponds to absolute dose differences ranging from 0.3 Gy to 1.5 Gy. A linear relationship was observed between calculated and measured doses with linear regression R2 value of 0.88, indicating close association between the measured and calculated doses. In general, absorbed doses for the rectum as calculated by TPS were observed to be higher than the doses measured using the diode probe. In-vivo dosimetry is an important quality assurance method for HDR brachytherapy of cervical cancer. It provides information that can contribute to the reduction of errors and discrepancies in dose delivery. Our study has shown that in-vivo dosimetry is feasible and can be performed to estimate the dose to the rectum during HDR brachytherapy using Co-60.  相似文献   

10.
BackgroundThe objective of the study was to dosimetrically compare the intensity-modulated-arc-therapy (IMAT), Cyber-Knife therapy (CK), single fraction interstitial high-dose-rate (HDR) and low-dose-rate (LDR) brachytherapy (BT) in low-risk prostate cancer.Materials and methodsTreatment plans of ten patients treated with CK were selected and additional plans using IMAT, HDR and LDR BT were created on the same CT images. The prescribed dose was 2.5/70 Gy in IMAT, 8/40 Gy in CK, 21 Gy in HDR and 145 Gy in LDR BT to the prostate gland. EQD2 dose-volume parameters were calculated for each technique and compared.ResultsEQD2 total dose of the prostate was significantly lower with IMAT and CK than with HDR and LDR BT, D90 was 79.5 Gy, 116.4 Gy, 169.2 Gy and 157.9 Gy (p < 0.001). However, teletherapy plans were more conformal than BT, COIN was 0.84, 0.82, 0.76 and 0.76 (p < 0.001), respectively. The D2 to the rectum and bladder were lower with HDR BT than with IMAT, CK and LDR BT, it was 66.7 Gy, 68.1 Gy, 36.0 Gy and 68.0 Gy (p = 0.0427), and 68.4 Gy, 78.9 Gy, 51.4 Gy and 70.3 Gy (p = 0.0091) in IMAT, CK, HDR and LDR BT plans, while D0.1 to the urethra was lower with both IMAT and CK than with BTs: 79.9 Gy, 88.0 Gy, 132.7 Gy and 170.6 Gy (p < 0.001). D2 to the hips was higher with IMAT and CK, than with BTs: 13.4 Gy, 20.7 Gy, 0.4 Gy and 1.5 Gy (p < 0.001), while D2 to the sigmoid, bowel bag, testicles and penile bulb was higher with CK than with the other techniques.ConclusionsHDR monotherapy yields the most advantageous dosimetrical plans, except for the dose to the urethra, where IMAT seems to be the optimal modality in the radiotherapy of low-risk prostate cancer.  相似文献   

11.
PurposeThree MOSkins dosimeters were assembled over a rectal probe and used to perform in vivo dosimetry during HDR brachytherapy treatments of vaginal cancer. The purpose of this study was to verify the applicability of the developed tool to evaluate discrepancies between planned and measured doses to the rectal wall.Materials and methodsMOSkin dosimeters from the Centre for Medical Radiation Physics are particularly suitable for brachytherapy procedures for their ability to be easily incorporated into treatment instrumentation. In this study, 26 treatment sessions of HDR vaginal brachytherapy were monitored using three MOSkin mounted on a rectal probe. A total of 78 measurements were collected and compared to doses determined by the treatment planning system.ResultsMean dose discrepancy was determined as 2.2 ± 6.9%, with 44.6% of the measurements within ±5%, 89.2% within ±10% and 10.8% higher than ±10%. When dose discrepancies were grouped according to the time elapsed between imaging and treatment (i.e., group 1: ≤90 min; group 2: >90 min), mean discrepancies resulted in 4.7 ± 3.6% and 7.1 ± 5.0% for groups 1 and 2, respectively. Furthermore, the position of the dosimeter on the rectal catheter was found to affect uncertainty, where highest uncertainties were observed for the dosimeter furthest inside the rectum.ConclusionsThis study has verified MOSkin applicability to in-patient dose monitoring in gynecological brachytherapy procedures, demonstrating the dosimetric rectal probe setup as an accurate and convenient IVD instrument for rectal wall dose verification. Furthermore, the study demonstrates that the delivered dose discrepancy may be affected by the duration of treatment planning.  相似文献   

12.
The oral cancer gene database has been compiled to enable fast retrieval of updated information and role of the genes implicated in oral cancer. The first version of the database with 242 genes was published in Online Journal of Bioinformatics 8(1), 41-44, 2007. In the second version, the database has been enlarged to include 374 genes by adding 132 gene entries. The architecture and format of the database is similar to the earlier version, and includes updated information and external hyperlinks for all the genes. The functional gene interaction network for important biological processes and molecular functions has been rebuilt based on 374 genes using 'String 8.3'. The database is freely available at http://www.actrec.gov.in/OCDB/index.htm and provides the scientist information and external links for the genes involved in oral cancer, interactions between them, and their role in the biology of oral cancer along with clinical relevance.  相似文献   

13.
AimThe aim of this study is to analyse the dosimetry to the pelvic lymph nodes and its correlation to point B using CT based high dose rate brachytherapy of carcinoma cervix.BackgroundConventionally, dose to pelvic lymph nodes from intracavitary brachytherapy was reported by point B and by the reference points of the lymphatic trapezoid.Materials and methods30 consecutive CT based high dose rate applications were reviewed between February and March 2016. The high risk clinical target volume and the organs at risk and the pelvic nodal groups were contoured. DVH parameters for the right and left obturator nodal group, right and left external iliac nodal group and right and left internal iliac nodal group were recorded. Right and left point B doses were also recorded.ResultsOn analysis of the combined dose, it was found that all the DVH parameters were significantly different from point B, except the D100 obturator and D2cc internal iliac lymph node. There was a significant correlation between all DVH parameters and point B, except D2cc, D1cc and D0.1cc of external iliac. The obturator group received the highest dose contribution from brachytherapy. The mean D90 dose received per fraction for the obturator, external iliac and internal iliac nodes was 2.7 Gy, 1.17 Gy and 1.41 Gy, respectively.ConclusionsThere is a significant dose contribution to the pelvic lymph nodal groups during intracavitary brachytherapy. There is a low degree of correlation between point B dose and dosimetric parameters of the individual nodal groups. Hence, it is important to analyse the dose delivered to individual nodal groups during intracavitary brachytherapy, at least in patients with enlarged lymph nodes to calculate the cumulative dose delivered.  相似文献   

14.
15.
PurposeA direct planning approach with multi-channel vaginal cylinders (MVCs) used for HDR brachytherapy of vaginal cancers is particularly challenging. Purpose of this study was to compare the dosimetric performances of different forward and inverse methods used for the optimization of MVC-based vaginal treatments for endometrial cancer, with a particular attention to the definition of strategies useful to limit the high doses to the vaginal mucosa.MethodsTwelve postoperative vaginal HDR brachytherapy treatments performed with MVCs were considered. Plans were retrospectively optimized with three different methods: Dose Point Optimization followed by Graphical Optimization (DPO + GrO), Inverse Planning Simulated Annealing with two different class solutions as starting conditions (surflPSA and homogIPSA) and Hybrid Inverse Planning Optimization (HIPO). Several dosimetric parameters related to target coverage, hot spot extensions and sparing of organs at risk were analyzed to evaluate the quality of the achieved treatment plans. Dose homogeneity index (DHI), conformal index (COIN) and a further parameter quantifying the proportion of the central catheter loading with respect to the overall loading (i.e., the central catheter loading index: CCLI) were also quantified.ResultsThe achieved PTV coverage parameters were highly correlated with each other but uncorrelated with the hot spot quantifiers. HomogIPSA and HIPO achieved higher DHIs and CCLIs and lower volumes of high doses than DPO + GrO and surflPSA.ConclusionsWithin the investigated optimization methods, HIPO and homoglPSA showed the highest dose homogeneity to the target. In particular, homogIPSA resulted also the most effective in reducing hot spots to the vaginal mucosa.  相似文献   

16.
BackgroundLocalized prostate cancer (T1–3N0M0) has therapeutic options such as radical prostatectomy (RP), external beam radiation therapy (EBRT) and brachytherapy (BT). However, the evidence of the outcome of these treatments is limited and no studies have been conducted comparing biochemical failure (BF) and toxicity associated with surgical treatment and EBRT + high-dose brachytherapy (HDBT) in the region.Materials and methodsRetrospective cohort study, clinical records of patients diagnosed with localized prostate cancer between 2014 and 2018 were reviewed at one of the main private neoplasm centers in Lima, Peru; Cox regression was used for both the BF outcome and the grade 2 toxicity outcome, calculating the hazard ratio (HR) with 95% confodence interval (CI).ResultsOf 549 patients, 76.3% (419) received RP as primary treatment, and 72% were between 50 and 70 years old at the time of diagnosis. The patients treated with EBRT + HDBT presented worse characteristics. The EBRT + HDBT group had a 40% lower risk of presenting BF (HR = 0.6; 95% CI: 0.4–0.9), and also a 50% greater risk of presenting toxicity greater than or equal to grade 2 (HR = 1.5; 95% CI: 1.0–2.0) than the group treated with RP.ConclusionOur results show that when comparing patients treated with EBRT + HDBT and RP, BF was greater in RP, and post-treatment toxicity was greater in EBRT + HDBT.  相似文献   

17.
Head and neck cancers, including oral squamous cell carcinoma (OSCC), are the sixth most common malignancy in the world and are characterized by poor prognosis and a low survival rate. Saliva is oral fluid with intimate contact with OSCC. Besides non‐invasive, simple, and rapid to collect, saliva is a potential source of biomarkers. In this study, we build an SRM assay that targets fourteen OSCC candidate biomarker proteins, which were evaluated in a set of clinically‐derived saliva samples. Using Skyline software package, we demonstrated a statistically significant higher abundance of the C1R, LCN2, SLPI, FAM49B, TAGLN2, CFB, C3, C4B, LRG1, SERPINA1 candidate biomarkers in the saliva of OSCC patients. Furthermore, our study also demonstrated that CFB, C3, C4B, SERPINA1 and LRG1 are associated with the risk of developing OSCC. Overall, this study successfully used targeted proteomics to measure in saliva a panel of biomarker candidates for OSCC.  相似文献   

18.
目的

研究鱼胶多糖对大鼠口腔溃疡的治疗效果以及鱼胶多糖治疗后大鼠口腔菌群的变化,旨在研究鱼胶多糖治疗口腔溃疡的效果及其原理。

方法

用90%石碳酸溶液诱导大鼠口腔溃疡,将模型大鼠随机分为空白组(不做溃疡处理),阳性对照组(西瓜霜涂抹),鱼胶组(鱼胶涂抹),自愈组(不用药)。阳性对照组和鱼胶组大鼠用药均为每天1次。于实验第4天,每组大鼠随机取7只进行口腔菌群样品分离并送测序公司进行16S rRNA基因测序,观察大鼠试验期间口腔溃疡创面的大小,体质量变化,耗粮量变化以及口腔菌群变化。

结果

阳性对照组大鼠口腔溃疡痊愈时间为(6.70±0.68)d,鱼胶组口腔溃疡痊愈时间为(6.70±0.57)d,自愈组口腔溃疡痊愈时间为(12.00±0.89)d,鱼胶组与自愈组相比差异有统计学意义(P<0.001)。16S rRNA基因测序结果显示,鱼胶组与自愈组之间差异菌群为黄单胞菌目(Xanthomonadales)、β变形菌目(Betaproteobacteriales)、厚壁菌门(Firmicutes)、乳杆菌目(Lactobacillales)、鞘脂杆菌目(Sphingobacteriales)、微球菌目(Micrococcales)、肠杆菌目(Enterobacteriales)、假单胞菌目(Pseudomonadales)、放线菌目(Actinomycetales)。

结论

鱼胶多糖可通过调节口腔菌群从而起到治疗口腔溃疡的作用。

  相似文献   

19.
Recent studies indicate that chronic inflammation promotes the aggressiveness of cancers. However, the direct molecular mechanisms underlying a functional link between chronic periodontitis, the most common form of oral inflammatory diseases, and the malignancy of oral cancer remain unknown. To elucidate the role of chronic periodontitis in progression of oral cancer, we examined the effect of Porphyromonas gingivalis (P. gingivalis), a major pathogen that causes chronic periodontitis, on the invasiveness of oral squamous cell carcinoma (OSCC) cells, including SCC-25, OSC-20 and SAS cells. Exposures to P. gingivalis promoted the invasive ability of OSC-20 and SAS cells via the upregulation of matrix metalloproteinases (MMPs), specifically MMP-1 and MMP-2. However, P. gingivalis-infected SCC-25 cells did not exhibit changes in their invasive properties or the low expression levels of MMPs. In an effort to delineate the molecular players that control the invasiveness, we first assessed the level of interleukin-8 (IL-8), a well-known inflammatory cytokine, in P. gingivalis-infected OSCC cells. IL-8 secretion was substantially increased in the OSC-20 and SAS cells, but not in the SCC-25 cells, following P. gingivalis infection. When IL-8 was directly applied to SCC-25 cells, their invasive ability and MMP level were significantly increased. Furthermore, the downregulation of IL-8 in P. gingivalis-infected OSC-20 and SAS cells attenuated their invasive potentials and MMP levels. Taken together, our findings strongly suggest that P. gingivalis infection plays an important role in the promotion of the invasive potential of OSCC cells via the upregulation of IL-8 and MMPs.  相似文献   

20.
目的 研究胃癌患者化疗前后口腔菌群与肠道菌群的变化特征,为该类患者的治疗提供参考.方法 选取2017年2月至2020年2月于我院接受治疗的96例胃癌患者为观察组,另外选取同期我院健康体检者90例为对照组,收集两组对象唾液样本和粪便样本,其中观察组患者需收集化疗前及化疗后两个时间点的样本.采用16SrRNA基因高通量测序...  相似文献   

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