胶滴肿瘤药敏检测技术对膀胱灌注化疗药物选择的临床研究

Clinical study of collagen gel droplet culture-drug sensitivity test for choosing intravesical chemotherapy of bladder cancer

目的研究胶滴肿瘤药敏检测技术对膀胱灌注化疗药物选择的作用。方法对145例行经尿道等离子电切的膀胱癌患者进行随访,根据是否采用肿瘤药敏检测分为两组,A组根据药敏检测技术采用吡柔比星、表柔比星、丝裂霉素或吉西他滨灌注化疗,B组不经药敏检测,根据经验仅采用吡柔比星灌注化疗。比较两组患者的年龄、性别、是否吸烟、肿瘤级别、肿瘤大小等基线资料;采用生存分析模型比较组间肿瘤复发率和复发时间。结果两组患者在年龄(P=0.2915)、性别(P=0.5268)、是否吸烟(P=0.8915)、肿瘤级别(P=0.1931)和肿瘤大小(P=0.1655)的差异无统计学意义;两组患者随访复发率比较有统计学差异(P=0.0298<0.05)。生存分析结果:两组之间复发时间差异有统计学意义(χ2=6.663,P=0.0098<0.05)。结论使用CD-DST法对体外原代膀胱尿路上皮癌细胞进行膀胱灌注化疗药物敏感度测定,可以有效选择敏感化疗药物,有效降低膀胱癌复发率,并有效推迟膀胱癌复发时间,为膀胱灌注化疗的个体化药物选择上,有重要意义。

Objective To study the collagen gel droplet culture-drug sensitivity test（CD-DST） for choosing intravesical chemotherapy of bladder cancer. Methods According to the drug susceptibility testing technology,145 transurethral bladder cancer patients were divided into two groups.Group A used topiramate,doxorubicin,epirubici n, mitomycin,or gemcitabine chemotherapy and Group B used topiramate or doxorubicin without drug susceptibility testing.Comparing the basic data of patients,such as age,sex,smoking,tumor grade and tumor size.Tumor recurrence and recurrence interval can be found by using cox survival curve model. Results There were not significant differences in age（P=0.2915）, sex（P=0.5268）, smoking（P=0.8915）,tumor grade（P=0.1931）,and tumor size（P=0.1655）,while it was statistically significant（P=0.0298 0.05） in terms of relapse rate.The use of the drug susceptibility method to select sensitive bladder perfusion,would delay tumor recurrence（χ^2=6.663,P=0.0098 0.05）. Conclusion CDDST method of primary urothelial bladder cancer infusion chemotherapy sensitivity assay can effectively choose the sensitive chemotherapy drugs to effectively reduce the recurrence rate of bladder cancer in vitro.It is important to postpone the time of bladder cancer recurrence and effectively to choose intravesical individualized chemotherapy.