进展期胃癌原发灶、转移灶及外周血单个核细胞体外药敏相关性研究

Study of correlation of drug sensitivity among primary lesion,metastasis and peripheral blood mononuclear cells of progressive gastric cancer in vitro

目的:对胃癌原发灶、转移灶和外周血单个核细胞(PBMCs)的体外药敏及其相关性进行研究,为实现胃癌个体化化学疗法(化疗)提供依据。方法:将来手术切除的36例胃癌病人肿瘤组织、转移淋巴结标本和外周血标本,采用MTT法分别检测氟尿嘧啶(FU)、顺铂(CDDP)、奥沙利铂(L-OHP)、伊立替康(CPT-11)、氟尿嘧啶+顺铂和氟尿嘧啶+奥沙利铂6种方案对3种不同组织细胞的抑制率。结果:3种不同组织细胞对6种化疗方案的敏感性,差异均有显著意义(P<0.01),转移淋巴结和癌组织细胞对4种化疗方案(FU、L-OHP、CPT-11、和FU+L-OHP)的敏感性差异无显著意义(P>0.05);转移淋巴结与癌组织细胞对5种化疗方案(FU、CDDP、L-OHP、CPT-11和FU+L-OHP)的敏感性呈正相关,而转移淋巴结细胞与PBMCs以及癌组织细胞与PBMCs仅对部分化疗方案的敏感性呈正相关。结论:肿瘤术后病人根据转移灶药敏结果指导个体化化疗具有科学性。根据原发灶体外药敏结果指导化疗亦可能获得相同效果。

AIM： To investigate the correlation of drug sensitivities among tumor cells, metastatic lymphnode cells and peripheral blood mononuclear cells （PBMCs） in vitro in order to provide new evidence for gastric cancer individualized chemotherapy. METHODS： Thirty-six tumor tissues and metastatic lymph node specimens from the patients with gastric cancer were undertaken mechanical dispersion method for single cell suspension respectively, and 36 peripheral blood specimens were treated by lymphocyte separating medium. The optical density （D） values were detected by MTT method and the cell inhibition （CI） values to 6 kinds of chemotherapy scheme were calculated according to the formula. RESULTS： Drug sensitivity discrepancy among different tissue cells showed obvious significance （P 〈 0.01 ）, and the drug sensitivity discrepancy between metastatic lymph-node cells and tumor cells was not conspicuous （P 〉 0.05） . There was a significant positive correlation in the drug sensitivities between metastatic lymph-node cells and tumor cells to the most of the chemotherapy schemes, and also a significant positive correlation in the drug sensitivities between metastatic lymph-node cells and PBMCs as well as between tumor cells and PBMCs to the parts of chemotherapy schemes. CONCLUSION： Individualized chemotherapy based on drug sensitivity of metastasis is more scientific, which could be obtained with the same drug sensitivity effect of primary lesion in vitro as well.