晚期肿瘤患者外周血淋巴细胞体外药敏试验与临床疗效的相关性研究

Research on correlation between chemosensitivity of peripheral blood lymphocytes in vitro of advanced stage tumor and the therapeutic effect

目的:研究晚期肺癌、乳腺癌患者外周血淋巴细胞体外化疗药物敏感性与临床疗效的关系,为临床个体化化疗提供依据。方法:采用MTT法测定17例晚期肺癌、14例晚期乳腺癌患者的外周血淋巴细胞对8种常用化疗药物的敏感性,并依据药敏结果选择化疗方案,同时选取依照传统经验化疗的晚期肺癌和乳腺癌患者各20例作为对照组,比较两组的临床疗效是否存在统计学差异。结果:①17例晚期肺癌患者外周血淋巴细胞对8种化疗药物的敏感顺序依次为:顺铂、紫杉醇、吉西他滨、卡铂、长春瑞滨、环磷酰胺、氟尿嘧啶、阿霉素;14例晚期乳腺癌患者外周血淋巴细胞对8种化疗药物的敏感顺序依次为:环磷酰胺、阿霉素、氟尿嘧啶、紫杉醇、顺铂、卡铂、吉西他滨、长春瑞滨。②药敏试验敏感并用于临床有效的共27例,有效率为87.1%(27/31),与对照组(55%)相比差异具有统计学意义(P<0.01)。结论:恶性肿瘤患者的外周血淋巴细胞可替代肿瘤细胞进行体外药敏试验检测,帮助临床医师制定合理的化疗方案,有助于提高恶性肿瘤患者的临床疗效和远期生存率。

Objective： To investigate the relationship between Chemosensitivity of peripheral blood lymphocytes in vitro and the therapeutic effect, in order to provide the guidance for individual chemotherapy in patients with lung cancer or mammary cancer. Methods： Chemosensitivity to 8 connonly used chemotherapeutics of peripheral blood lymphocytes in vitro of 31 cases with lung cancer or mammary cancer was determined by MTT assay and chemotherapeutic regimens were selected according to the results of chemosensitivity. At the same time,we choose 40 cases of lung cancer or mammary cancer as a case in the control group which afford conventional chemotherapeutic regimens. To compare the clinical effect of two groups with significant difference. Results：（1）The chemosensitivity order for 17 cases with lung cancer,which was DDP, taxinol, Gemcitabine, carboplatin, vinorelbine, Cytoxan, fluorouracil, ADM; The chemosensitivity order for 14 cases with mammary cancer, which was Cytoxan, ADM, fluorouracil, taxinol, DDP, carboplatin, Gemcitabine, vinorelbine. （2）The coincidence rate of chemosensitivity in vitro and therapeutic effects was 87.1% （27/31 ）, there is statistical significance compared with the control group（55% ） （P 〈 0.01 ）. Conclusion ：Peripheral blood lymphocytes could replace tumor cells, and chemo- therapy under the guidance of chemosensitivity in vitro may improve the therapeutic effect and the long term survival rate of patients with malignant tumor.