直肠癌体外药敏试验与临床疗效的相关性研究

Research on the relationship between chemosensitivity in vitro and clinical chemotherapy in carcinoma of rectum

目的研究直肠癌体外药物敏感性与临床疗效的相关性,为临床肿瘤个体化化疗提供依据。方法将同期98例直肠癌,分别分为MTT试验组和对照组。接受MTT药敏实验者,根据药敏结果分为敏感组和不敏感组,敏感组根据药敏结果指导化疗,不敏感组和对照组采用常规化疗方案化疗,观察各组临床近期疗效和3年生存率。结果56例直肠癌组织对5种化疗药物的体外敏感性顺序依次为:丝裂霉素、羟基喜树碱、5-氟尿嘧啶、顺铂、阿霉素,与临床实践不完全一致。MTT敏感组、不敏感组与对照组近期临床有效率分别为:75.0%(30/40)、14.3%(1/7)和51.4%(18/35),差异存在显著性(P<0.05)。MTT敏感组、不敏感组与对照组的3年生存率分别为65.7%(23/35)、0%(0/6)和47.1%(16/34),差异存在显著性(P<0.05)。结论MTT药敏试验结果有助于临床的个体化治疗和化疗效果的预测,有助于提高直肠癌患者的远期存活率。

[Objective] To study the relationship between chemosensitivity in vitro and clinical chemotherapy and to provide datas of individualization clinical chemotherapy in carcinoma of rectum. [Method] 98 patients with carcinoma of rectum were divided into two groups： MTr group and control group. Patients of MTr group were divided into sensitive group and less sensitive group by degree of chemosensitivity in vitro. MTr sensitive group was treated according to the result by MTr assay. MTr less sensitive group and control group were treaded by common chnical chemotherapy. Therapeutic effects for short term and the survival of three years in all groups were studied. [Result] The chemosensitivity order of drugs in 56 cases with carcinoma of rectum was mitomycin, hydroxycamptothecine, 5-Fluorouracil, cisplatin, adriblastine, and wasn＇t consistent with effect drugs for carcinoma of rectum proved by clinical practice. In all groups, therapeutic effects for short term was： the MTr sensitive group 75.0% （30/40）, the less sensitive group 14.3% （1/7） and the control group was 51.4% （18/35） （P 〈0.05）. In all groups, the survival of three years were： the MTr sensitive group 65.7% （23/35）, the less sensitive group 0% （0/6） and the control group 39.3% 47.1% （16/34） （P 〈0.05）. [Conclusion] The result of MTT assay in vitro is value to effects prediction of individualized chemotherapy in clinic and the rise of the long term survival rate of gastric cancer.