利用体外药敏试验指导膀胱癌临床个体化灌注化疗

Guiding clinical individual intravesical chemotherapy of bladder cancer by drugs sensitivity testing in vitro

目的研究根据体外药敏试验结果选择药物来指导临床膀胱癌患者的个体化膀胱内灌注化疗。方法选取25例非肌层浸润性膀胱癌患者手术标本作原代细胞培养及化疗药物敏感试验,选择敏感的化疗药物对患者进行膀胱内灌注治疗,随访7年观察肿瘤复发率。结果25例组织标本中24例完成实验。各化疗药物总体敏感率差异无统计学意义(P>0.05),但每种化疗药物对不同个体的敏感率差异较大。24例患者膀胱灌注化疗的5年复发率为16.7%(4/24),7年复发率为25.0%(6/24),5例对4种化疗药物均耐药的患者中3例复发。结论体外药敏试验筛选的药物与膀胱内灌注化疗临床疗效间有良好的相关性,为个体化治疗提供了有价值的临床指导。

Objective To study to carry out clinical individual intravesical chemotherapy in bladder cancer patients by the guidance of drugs sensitivity testing in vitro. Methods Chemosensitivity of 25 non muscle-invasive bladder cancer tumors for four chemotherapeutic drugs from different individuals was studied by means of primary tumor celt culture and MTT assay. These patients received intravesical chemotherapy with the highest sensitivity agent on the basis of MTT assay results. Patients were followed up for seven years to observe the recurrence of bladder cancer. Results The MTT assay was successfuly performed in 24 of the 25 patients. There was no significant difference of sensitivity of four chemotherapeutic drugs（P〉0.05）. However, diversity of chemosensitivity was observed in samples from different individuals for certain agent. The five-year recurrence rate was 16.7 % （4/24） of bladder cancer. The seven-year recurrence rate was 25.0% （6/24） of bladder cancer . Three patients recurred of five cases which were resistant to four chemotherapeutic drugs. Conclusions Chemotherapeutic drugs selected by drugs sensitivity testing in vitro have good correlation with the clinical outcome of intravesical chemotherapy and provide a valuable guidance for individual intravesical chemotherapy.