抗肿瘤药体外药敏与大肠癌疗效和预后的相关性

Correlation Between in vitro Chemosensitivity of Antineoplastic Drugs and its Clinical Response and Prognosis in Human Colorectal Cancers

目的:探讨氟尿嘧啶(5-Fu)联用丝裂霉素(MMC)治疗大肠癌的体外药敏与临床化疗疗效和预后的相关性。方法:用MTT法测定联合化疗方案5-Fu+MMC对169例Dukes B、C期大肠癌的体外敏感性,统计术后4年内复发率和预后。结果:将使用5-Fu、MMC联合化疗的100例,按体外药敏分成拮抗组28例,复发率57．1％;协同、相加组72例,复发率22．2％(P<0．01)。再将这100例分成体外耐药组31例,复发率45．2％;体外敏感组69例,复发率24．6％(P<0．05)。Cox多因素分析显示,体外药敏为拮抗,则死亡相对风险度增加4．56倍。结论:5-Fu、MMC体外发生协同相加、拮抗作用、敏感和耐药,都可以作为预测大肠癌临床化疗疗效的指标,但前者与预后相关,后者不相关。

Objective： To study the correlation between in vitro chemosensitivity of Fluorouraci（5-Fu） ＋ Mitomycia（MMC） and its clinical response and prognosis in human colorectal cancers. Method： The chemosensitivity of 5-Fu ＋ MMC was tested in 169 Dukes B and C colorectal cancers with the MTT method,and the progression-free internal and prognosis in 4 years following the surgery were observed, Result： Based on the in vitro chemosensitivity of 5-Fu ＋ MMC, 100 patients were divided into an antagonistic group（28 patients） in which their relapse rates were 57.1% and a synergistic-additive group（72 patients） in which their relapse rates were 22.2% （P 〈0. 01 ）. We divided the same 100 patients into an insensitive group （31 patients） in which their relapse rates were 45.2% and a sensitive group （69 patients） in which their relapse rates were 24.6% （ P 〈 0.05 ）. The multivariate analysis indicated that the relative death risk increased by 4.56 times in the case of in vitro antagonism. Conclusion： All the in vitro synergism, addition, antagonism and sensitivity or insensitivity of 5-Fu ＋ MMC could acted as the guidelines of chemotherapeutic results in colorectal cancers, but the former was related to the prognosis, and the latter was not.