组织培养药敏测试法在表浅膀胱肿瘤化疗药敏测试中的应用价值

The initial application of bladder carcinoma's histoculture drug response assay

目的:探讨Hoffman式组织培养药敏测试法在表浅膀胱癌腔内化疗药敏测试中的应用价值。方法:对31例表浅膀胱癌分别进行Hoffman式组织培养,对丝裂霉素C(MMC)进行改良MTT法药敏测试,检测MMC在浓度为1g/L、作用时间为2h情况下对表浅膀胱癌的生长抑制率。采用MMC 40mg加生理盐水40ml对表浅膀胱癌进行术后标准腔内化疗,并随访20个月。结果:18例培养成功,15例进入药敏测试,其中9例对MMC敏感,6例不敏感。术后腔内化疗随访结果显示敏感者有2例复发,不敏感者有5例复发;单因素Kaplan-Meier生存分析显示敏感者无复发生存率明显高于不敏感者。与临床实际疗效比较,该药敏测试法的特异性为75.0％,敏感性为85.7％,准确率达80.0％。结论:组织培养药敏测试法不仅可以检测表浅膀胱癌对化疗药物的敏感性,还能预测利用敏感药物进行腔内化疗的预后。

Purpose:The present study try to find out applicable value of Hoffman histoculture drug response assay (HDRA) in bladder carcinoma intravesical chemotherapy. Methods: Thirty one cases of superfical bladder transitional cell carcinoma (TCC) were cultured by means of Hoffman three-dimensional histoculture. The improved MTT assay was utilized for chemosenstivity test of mitomycin C (MMC) to superficial bladder TCC with 1 g/L concentration and 2 hours exposure. All sufercifal bladder TCC were performed standard intravesical chemotherapy with MMC 40 mg plus 40 ml saline. Every case was followed-up for 20 months. Results; Eighteen cases were successfully cultured, 15 cases of cultured samples were performed chemosenstivity test, 9 cases of those were sensitive to MMC while 6 cases were insensitive. Two cases of sensitive group were recurrent and 5 cases of insensitive group were recurrent. The recurrence-free survival rate evaluated according to Kaplan-Meier was significantly better in sensitive group than in insensitive group ( P =0. 008 6). There was a 80. 0% correlation rate of HDRA to the clinical effects of chemotherapy With 75. 0% specificity and 85. 7% sensitivity. Conclusions:Bladder carcinoma HDRA with improved MTT assay is not only a chemosenstivity test for detecting drug sensitivity to intravesical chemotherapy of sufercifal bladder TCC, but also a prognostic marker of patient survival.