ATP-TCA技术指导表浅性膀胱癌灌注化疗的可行性研究

Study on ATP-TCA directing drug selection in intravesical chemotherapy for superficial bladder cancer

目的:探讨ATP生物荧光体外肿瘤药敏检测技术(ATP-TCA)指导膀胱癌术后灌注化疗的可行性。方法:对46例新鲜膀胱癌标本进行肿瘤细胞分离,原代培养;应用ATP-TCA技术检测肿瘤标本对三种常用化疗药物[吡柔比星(THP)、丝裂霉素(MMC)、表阿霉素(EPI)]的敏感率和耐药率。结果:46例标本中,THP、MMC和EPI的敏感率分别为82·46%、63·04%和39·13%,肿瘤细胞对三种化疗药物的敏感率和耐药率差异有统计学意义,P<0·01;26例相同组织学类型和分化程度(T1G2)的膀胱癌中,THP、MMC和EPI的敏感率分别是88·61%、61·54%和24·62%,敏感率和耐药率差异仍有统计学意义,P<0·01。膀胱肿瘤对化疗药物的敏感性存在个体差异。结论:应用ATP-TCA技术测出的药敏结果能够反映个体对化疗药物的敏感性,可以作为选择灌注化疗用药的理论基础,指导临床用药,进行个体化治疗。

OBJECTIVE:To evaluate the feasibility of using ATP-TCA in vitro, which used for the guide of drug selection in those patients who received intravesical chemotherapy to prevent the recurrence of superficial bladder cancer after operation. METHODS: Forty-six fresh sterilized bladder superficial transient cell carcinoma specimens were purified and then primary tumor cell were cultured. ATP directed tumor chemo-sensitivity assay was done with THP, MMC and EPI sequentially. The results of sensitivity and tolerance rates were dealt with statistically. RESULTS: The sensitivity proportions of the 46 tumors for THP, MMC and EPI were 82.46%, 63.04% and 39.13% sequentially. The difference had statistical significance, P<0.01. The sensitivity proportions of the 26 T_1G_2 for THP, MMC and EPI were 88.61%, 61.54% and 24.62% sequentially. The difference also had statistical significance, P<0.01. There existed individual differences with different patients and different drugs. CONCLUSIONS: The results of ATP-TCA in vitro could reflect the real sensitivity of the individuals to different drugs and it could be the proof of directing the clinical therapy to apply the individual chemotherapy.