5种化疗药物对维吾尔族直肠癌患者的敏感性及疗效评价

Evaluation of sensitivity and curative effect of five colorectal cancer chemotherapy drugs on colorectal cancer cells in Uygur patients

目的:评估氟尿嘧啶、吉西他滨、顺铂、奥沙利铂和伊立替康直肠癌化疗药物对维吾尔族直肠癌患者癌细胞的敏感性及疗效。方法:选取维吾尔族直肠癌患者组织标本,MTT法行药敏试验,倒置荧光显微镜观察化疗药物对直肠癌细胞形态的影响。60例直肠癌患者随机分为5-Fu组(5-氟尿嘧啶+亚叶酸钙)、FOLFOX组(5-氟尿嘧啶+亚叶酸钙+奥沙利铂)、FOLFIRI组(5-氟尿嘧啶+亚叶酸钙+伊立替康),每组各20例;疗程结束后,采用MRI检查盆腔,得到扩散加权成像图像上肿瘤的表观扩散系数(ADC)值,用全自动电化学免疫测定系统检测血清中癌胚抗原和CA19-9水平。结果:5-氟尿嘧啶、奥沙利铂和伊立替康对维吾尔族直肠癌细胞抑制率显著高于吉西他滨和顺铂(P <0. 05);直肠癌细胞可见凋亡细胞核及胞质中有致密浓染颗粒状荧光,核染色质凝聚且边缘化,或玻珠化,5-氟尿嘧啶、奥沙利铂和伊立替康组凋亡细胞核及胞质中荧光颗粒较顺铂组和吉西他滨组明显增多。治疗后各组ADC值均高于治疗前(P <0. 05)。治疗前3组ADC值差异无统计学意义,而治疗后FOLFIRI组和FOLFOX组ADC值明显高于5-Fu组(P <0. 05); FOLFIRI组癌胚抗原和CA19-9表达水平与FOLFOX组差异无统计学意义(P> 0. 05),但两组二者表达明显低于5-Fu组(P <0. 05)。结论:5-氟尿嘧啶、奥沙利铂和伊立替康对维吾尔族直肠癌患者癌细胞具有较高的敏感性,含奥沙利铂的FOLFOX方案和含伊立替康的FOLFIRI方案可有效改善患者预后。

Objective:To evaluate the sensitivity and efficacy of 5-fluorouracil,gemcitabine,cisplatin,oxaliplatin and irinotecan colorectal cancer chemotherapy drugs for colorectal cancer cells in Uygur patients.Methods:Tissue samples from Uighur patients with colorectal cancer were tested for susceptibility by MTT assay.Inverted fluorescence microscopy was used to observe the effect of chemotherapeutic drugs on the morphology of colorectal cancer cells.A total of 60 patients with colorectal cancer were randomly divided into 5-Fu group(5-fluorouracil+leucovorin),FOLFOX group(5-fluorouracil+leucovorin+oxaliplatin),FOLFIRI group(5-fluorouracil+leucovorin+irinotecan),20 patients in each group;after the end of the treatment course,the pelvic cavity was examined by MRI to obtain the tumor signal(ADC value)on the MRI diffusion-weighted imaging(DWI)image and the level of tumor markers carcinoembryonic antigen(CEA)and CA19-9 in serum was detected by a fully automatic electrochemical immunoassay system.Results:The inhibition rates of 5-fluorouracil,oxaliplatin and irinotecan on Uygur colorectal cancer cells were significantly higher than that of gemcitabine and cisplatin(P<0.05).The colorectal cancer cells structure showed apoptotic nucleus and there were densely stained with granular fluorescence in cytoplasm,with nuclear chromatin coagulated and marginalized,or beaded,the number of apoptotic nucleus of 5-fluorouracil,oxaliplatin and irinotecan was higher than that of cisplatin and gemcitabine group.After treatment,the ADC values of each group were higher than those before treatment(P<0.05).The ADC values of the three groups were no difference before treatment,while the ADC values of FOLFIRI group and FOLFOX group were significantly higher than that of 5-Fu group(P<0.05).There was no significant difference in the expression of CEA and CA19-9 between FOLFIRI group and FOLFOX group(P >0.05),while both of them in FOLFOX group and FOLFIRI group were significantly lower than in the 5-Fu group(P<0.05).Conclusion:5-Fluorouracil,oxaliplatin and irinotecan are highly sensitive to Uigur colorectal cancer patients.The FOLFOX regimen and FOLFIRI regimen with oxaliplatin or irinotecan could effectively improve the prognosis of patients.