体外化疗药敏试验系统联合流式细胞仪在胃肠肿瘤化疗中的应用

Application of in vitro ATP tumor chemosensitivity assay and flow cytometry in the chemotherapy of gastrointestinal carcinoma

目的探讨体外化疗药敏试验系统(ATP-TCA系统)联合流式细胞仪(FCM)在胃肠肿瘤化疗中的应用。方法取36例胃癌、结直肠癌的手术标本行ATP-TCA试验和FCMP170检测,并分析两者结果之间的关系。结果ATP-TCA的可评估率为88.1%;10种化疗药物的敏感率分别为:氟尿嘧啶15.6%,顺铂18.8%,足叶乙甙21.9%,草酸铂25.0%,丝裂霉素31.3%,表阿霉素37.5%,诺消灵40.6%,开普拓43.8%,健择53.1%,泰素56.3%。P170检测阳性率为43.8%;丝裂霉素、表阿霉素、诺消灵的敏感率在P170阴性表达时高,开普拓、健择、泰素在P170阳性和阴性表达时的敏感率均高,且差异无显著性意义(P>0.05)。结论ATP-TCA法联合FCM可较好地用于胃肠肿瘤的化疗药物的筛选;开普拓、健择、泰素可用于P170阳性表达的患者。

Objective To investigate the application of in vitro ATP tumor chemosensitivity assay (ATP TCA) and flow cytometry (FCM) in the chemotherapy of gastrointestinal carcinoma. Methods Surgical specimens from 36 patients with gastric or colorectal carcinoma were tested by the ATP TCA and FCM. Results Evaluable test results were achieved in 32 of 36 patients and the evaluable rate was 88 1%. The sensitive rates of 5 fluoruracil (5 FU), cisplatin (CDDP), oxaliplatin (OXA), etoposid(VP 16), mitomycin C (MMC), epirubicin (EPI), mitoxantron (MIT), irinotecan (CPT), gemcitabine (GEM), paclitaxl (TAX) were 15 6%, 18 8%, 21 9%, 25 0%, 31 3%, 37 5%, 40 6%, 43 8%, 53 1%and 56 3%respectively. The positive rate of P170 was 43 8%. The sensitive rates of MMC, MIT, EPI were higher in the cases with negative P170 than those with positive P170. The sensitive rates of CPT, GEM, TAX were high, but there was no statistical difference between the cases with negative and positive P170. Conclusions ATP TCA combined with FCM can be applicated in the screening of chemotherapeutic agents for gastrointestinal carcinoma. CPT, GEM, PAC may be applicable in the patients with positive P170.