胶滴肿瘤药敏检测技术在胃癌术后化疗中的应用

The Application of Collagen Gel Droplet-Embedded Culture Drug-Sensitivity Test in Postoperative Chemotherapy of Gastric Cancer

目的:探讨胶滴肿瘤药敏检测技术(CD-DST)对胃癌化疗的指导作用及临床应用可行性。方法:将53例胃癌患者的手术标本分别对阿霉素、依托泊苷、奥沙利铂、顺铂、5-氟尿嘧啶、丝裂霉素6种化疗药物进行CD-DST,并将其中对FOLFOX4方案(奥沙利铂、5-氟尿嘧啶和亚叶酸钙)中至少1种药物体外有效者31例作为实验组,未行药敏试验而以FOLFOX4方案作为经验治疗的35例患者作为对照组,2组患者均给予FOLFOX4方案化疗,观察并比较2组患者的术后1年和3年生存率及不良反应发生率。结果:(1)6种药物均有敏感患者;8例患者对任6种药物均不敏感,26例(49.1%)只对1种药物敏感。(2)实验组和对照组1年生存率(93.5%vs85.7%)差异无统计学意义(P>0.05),3年生存率(83.9%vs60.0%)差异有统计学意义(P<0.05)。结论:CD-DST技术对于胃癌个体化治疗的化疗方案选择具有一定指导意义。

Objective： To investigate the guiding role and feasibility of collagen gel droplet-embedded culture drug-sensitivity test （CD-DST） technology in postoperative chemotherapy for gastric cancer. Methods： The surgery-specimens of fifty-three patients with gastric cancer were carried out the CD-DST test for adriamycin, etoposide, oxaliplatin, cisplatin, 5-FU and mitomycin. Thirty-one patients confirmed to be effective in vitro with FOLFOX4 （L-OHP,5-FU and CF） were included in pilot group, and thirty-five patients accepted FOLFOX4 without CD-DST were in control group. The chemotherapy of FOLFOX4 was used in patients of two groups. The postoperative and three-year survival rate and incidence of adverse reaction were compared between the two groups. Results： （1） Eight patients were insensitive to any of six drugs. Most patients（26, 49.1%） were sensitive to only one of six drugs. （2）There was no significant difference in one-year survival rate between pilot group （93.5%） and control group （85.7%） （P〉0.05）.However, there was a significant difference in three-year survival rate between pilot group （83.9%） and control group （60.0%）（P〈0.05）. Conclusion： CD-DST technology plays an important role in the choice of chemotherapy program for individual treatment of gastric cancer patients.