胶滴肿瘤药敏检测技术评价卡培他滨对胃癌体外药敏实验的条件探索

Study on the experimental conditions of capecitabine by collagen gel droplet embedded culture drug sensitivity test for gastric cancer

目的采用胶滴肿瘤药敏检测技术(CD-DST)研究在胃癌术后辅助化疗中卡培他滨(CAP)药敏检测的实验条件。方法由于CAP在体外无法由肿瘤细胞直接代谢,本研究采用其代谢产物5'-脱氧-5-氟尿苷(5'-DFUR)评价CAP的药敏检测条件,对5'-DFUR的CD-DST实验条件进行探索。将31例实验组新鲜胃癌组织标本进行CD-DST检测,以未用药物处理组作为对照,分别以1μg/ml奥沙利铂(L-OHP)、0.03μg/ml伊立替康(CPT-11)和5'-DFUR(浓度为3、5、10μg/ml)进行处理,评价其体外有效率(IVS)与临床有效率的一致性,另将34例验证组新鲜胃癌组织标本进行验证。结果5μg/ml的5'-DFUR处理组的高敏感IVS为31%,与研究报道的CAP临床有效率约为30%一致。采用5μg/ml的5'-DFUR对另外34例胃癌标本进行验证,验证组中5'-DFUR(5μg/ml)处理组高敏感IVS为30%,与实验组IVS结果一致。结论在胃癌辅助化疗中,5μg/ml的5'-DFUR为CD-DST法评价CAP药物敏感性的实验条件,其检测结果IVS与临床有效率一致,为临床胃癌患者术后采用CDDST法进行CAP体外药敏实验提供指导。

Objective To study the experimental conditions of using capecitabine(CAP)as postoperative adjuvant chemotherapy for gastric cancer by the collagen gel droplet embedded culture drug sensitivity test(CD-DST).Methods Since CAP could not be directly metabolized by tumor cells in vitro,the experimental conditions of the drug-sensitive test of CAP was evaluated by its metabolite 5'-deoxy-5-fluorouridine(5'-DFUR),in other words,the experimental conditions of CD-DST for 5'-DFUR were explored.The fresh tissue specimens of 31 patients with gastric cancer were analyzed with the CD-DST;a group without treatment was employed as control,and another three groups were treated with 1μg/ml oxalipatin(L-OHP),0.03μg/ml irinotecan(CPT-11)or 5'-DFUR(as subgroups treated with concentrations of 3,5 and 10μg/ml),respectively,and then the consistency between in vitro sensitivity(IVS)and clinical response rate was evaluated,additionally,another 34 cases of fresh gastric cancer tissues were used to validate the findings.Results The rate of high IVS in the 5μg/ml 5'-DFUR group was 31%,which was consistent with the reported clinical response rate of about 30%for CAP.To further verify the results,another 34 surgical specimens of gastric cancer were treated with 5μg/ml of 5'-DFUR and detected by CD-DST,resulting in a high IVS of 30%,which again matched the findings in the treatment group.Conclusion The IVS observed under the experimental conditions of 5μg/ml 5'-DFUR by CD-DST demonstrates high consistency with clinical response rate,hence it is referential for the in vitro drug sensitivity test of CAP by CD-DST in patients with gastric cancer clinical practice.