Mechanism of drug resistance and reversal with ligustra-zine and cyclosporin A in cisplatin--inducedhuman epithelial ovarian cancer resistant cell line 3Ao/cDDP

Objective: To investigate the mechanism of resistance and reversal effect of ligustrazine and cyclosporin A in cisplatin--induced multidrug resistance ovarian cancer cell line 3Ao/cDDP. Methods: Using the corresponding dose calculated from clinical chemotherapy at 30 mg cisplatin per cycle, we established 3Ao/cDDP with 3Ao exposed at regular intervals and repeatedly to high-level concentration of cisplatin at 10 mg/ml for 24 hours each time. Expressions of LRP, MRP, P-gp, GSTp and TopoII were quantitatively detected with FCM. For drug resistance reversal, cyclosporin A and ligustrazine were administered singly or in combination at the maximal dose without cytotoxicity. Inhibition rates were determined by MTT assay. Results: 3Ao/cDDP was established after 4.5 months, with resistance factor 1.6 which was similar to clinical resistance degree. Low expression levels of MRP and P-gp were found in both 3Ao and 3Ao/cDDP (P>0.05), and LRP and GSTp expression levels in 3Ao/cDDP were significantly higher than those in 3Ao (P<0.005 and P<0.05, respectively), and TopoII in 3Ao/cDDP was significantly lower vs 3Ao (P<0.05). The inhibition rate of cDDP was 20.807±0.015%, cDDP plus ligustrazine 27.421±0.07% (P>0.05 vs cDDP), cDDP plus cyclosporin A 49.635±0.021% (P<0.01 vs cDDP), and cDDP plus ligustrazine and cyclosporin A 58.861±0.014% (P<0.01 vs cDDP). Conclusions: 3Ao/cDDP, induced by cisplatin and established by imitating the characteristics of clinical chemotherapy for epithelial ovarian cancer, was an ideal model for investigation of cisplatin resistance in vitro. Cisplatin resistance in 3Ao/cDDP could be accounted for by higher LRP, GSTp and lower TopoII expression and was not associated with MRP or P-gp. Ligustrazine had no significant reversal effect on cisplatin resistance, but cyclosporin A could reverse the resistance effectively.

WHAT SHOULD BE KEPT IN MIND FOR MANAGEMENT OF THE TOXIC SIDE-EFFECTS INDUCED BY POSTOPERATIVE CHEMO-AND RADIOTHERAPY FOR OVARIAN TUMOR?

Ovarian tumor may occur in women ofany age, but mostly seen in women duringtheir child-bearing period. The disease shouldbe treated mainly by surgical operation,supplemented by radiotherapy and chemo-therapy. However, the above therapies maycause a series of toxic side-effects, such asalopecia, diarrhea, edema, anorexia, nausea,dry mouth, spontaneous perspiration, headache,

SCREENING OF DRUG RESISTANCE-RELATED GENES FROM HUMAN OVARIAN CANCER CELL LINE OC3/ADR BY DD-PCR

Objective: To screen novel genes related to adriamycin (Adr) resistance from human ovarian cancer resistance cell line OC3/Adr. Methods: Multidrug resistant ovarian cancer cell line OC3/Adr was induced by intermittent treatment of the human parent cell line OC3 with high concentration Adr. The difference of gene expression was screened by using different display analysis to the acquired Adr-resistance subline OC3/Adr and its parent cell line OC3. Results: OC3/Adr cell line was obtained which was more resistance to Adr than the parent cell line OC3 with the resistance index (RI) of 15.4. The OC3/Adr cell line also showed cross-resistance to other anti-cancer drugs (VP16, CDDP,5FU). It grew slowly and exhibited changes of cell cycle. A number of differentially expressed ESTs (Expressed Sequence Tags, ESTs) were identified at mRNA level between the OC3/Adr and OC3. Four of 18 different ESTs were sequenced. The 431/432 base pair S1 was homologous to human sperm zona pellucida binding protein, while the other two ESTs, S3 and S4, were new gene segments, which were registered to GenBank with the number of AF 117656 and AF 126507 respectively. Particularly, the expression of S2 sequence increased in all the drug-resistance cell lines and S3 sequence overexpressed in human ovarian cancer tissues as compared with benign ovarian tumors. Conclusion: Drug resistance induced by Adr in ovarian cancer OC3/Adr is involved with changes of multiple gene expressions.

血流向量成像技术评估卵巢癌术后化疗后左心室舒张功能

目的观察血流向量成像(VFM)技术评估卵巢癌(OC)术后化学治疗(简称化疗)后左心室舒张功能改变的价值。方法前瞻性以37例OC术后接受化疗患者为化疗组,以同期40名健康成人为对照组。对化疗组分别于化疗前、化疗3及6个周期后,对照组于入组时行常规超声心动图及VFM检查,比较化疗前组间及化疗组内不同时间点资料,分析化疗组VFM与血红蛋白及常规超声心动图结果的相关性。结果化疗组年龄、体质量、体表面积(BSA),化疗前血红蛋白水平、常规超声心动图及VFM结果与对照组差异均无统计学意义(P均>0.05)。化疗组内,随化疗周期增加,血红蛋白水平渐次降低、等容舒张期(IR)及心房收缩期(AS)左心室内压力差(IVPD)及压力差梯度(IVPG)逐渐增大(校正P均<0.05);而常规超声心动图仅化疗6个周期后左心房容积指数(LAVI)及二尖瓣舒张早期血流峰值速度/二尖瓣环舒张早期平均运动峰值速度(E/e’)较化疗前升高(校正P均<0.05)。化疗组舒张期各时相VFM结果均与血红蛋白水平呈强相关(|r|=0.718~0.836,P均<0.05),与LAVI呈弱至中度相关(|r|=0.375~0.525,P均<0.05),与E/e’呈中度相关(|r|=0.424~0.537,P均<0.05)。结论OC术后化疗早期即可出现左心室舒张功能受损。VFM可较常规超声心动图更敏感地检出左心室舒张早期功能轻微改变。

乳腺癌易感基因联合癌抗原125动态监测在预测晚期上皮性卵巢癌病人铂敏感性及预后中的价值

目的评估胚系乳腺癌易感基因(BRCA)联合动态监测血清癌抗原125(CA125)在晚期上皮性卵巢癌(EOC)病人初治铂敏感性预测及判断预后中的价值。方法收集并回顾性分析2017年1月至2020年1月在蚌埠医学院第一附属医院行满意减瘤术且术后采用TC(紫杉醇+卡铂)/TP(紫杉醇+顺铂)方案静脉化疗的EOC病人151例的临床病理资料。分析胚系BRCA与EOC病人临床病理特征之间的关系;计算曲线下面积(AUC)值等评估胚系BRCA、治疗早期血清CA125水平及两者联合预测晚期EOC病人初治铂敏感性的效能;分析胚系BRCA、治疗早期血清CA125与晚期EOC病人无进展生存期(PFS)的关系;并对所有EOC病人的PFS进行多因素生存分析。结果胚系BRCA致病突变率为28.5%(43/151)。胚系BRCA与确诊年龄、治疗前血清CA125、遗传性乳腺癌和卵巢癌(HBOC)家族史等具有相关性(P<0.05);胚系BRCA、第一周期化疗后血清CA125单独预测晚期EOC病人初治铂敏感性的AUC为0.63、0.76;胚系BRCA与第一周期化疗后血清CA125串联预测晚期EOC病人初治铂敏感性的效能最高,AUC为0.79,95%CI:(0.69,0.90),灵敏度为69.7%,特异度为89.2%;在晚期EOC病人中,BRCA野生型+第一周期化疗后CA125>35 U/mL组病人的PFS生存曲线显著低于BRCA突变型+第一周期化疗后CA125≤35 U/mL组、BRCA突变型+第一周期化疗后CA125>35 U/mL组、BRCA野生型+第一周期化疗后CA125≤35 U/mL组(P=0.013、0.007、0.003)。多因素Cox回归分析显示第一周期化疗后血清CA125水平是EOC病人肿瘤无进展生存时间(PFS)的独立预后因素。结论胚系BRCA联合血清CA125动态监测对晚期EOC病人铂敏感性及预后有一定的预测价值。胚系BRCA野生型且第一周期化疗后血清CA125水平未正常提示EOC病人铂耐药及易复发的风险高。

PARP抑制剂在上皮性卵巢癌中的耐药机制及解决策略

上皮性卵巢癌(epithelial ovarian cancer,EOC)的致死率在女性生殖系统恶性肿瘤中居首位。EOC的传统治疗方案是肿瘤细胞减灭术联合铂类药物为基础的化疗,但2年内仍有约70%的患者复发或耐药。多腺苷二磷酸核糖聚合酶[poly(ADP-ribose)polymerase,PARP]抑制剂通过对乳腺癌相关基因(breast cancer-related gene,BRCA)突变的肿瘤细胞发挥合成致死效应,为EOC提供了全新的治疗模式。PARP抑制剂为EOC靶向维持治疗带来重大突破,然而仍有患者在治疗中逐步耐药,主要的耐药机制包括同源重组修复途径恢复、药物靶点变化和致死性DNA损伤减少,目前的解决策略包括PARP抑制剂联合DNA损伤修复抑制剂、联合抑制同源重组修复通路的药物、联合传统抗癌方案、联合P-糖蛋白(P-glucoprotein,P-gp)抑制剂以及更换其他类型的PARP抑制剂。

微流控技术在卵巢癌疾病建模、药物评估、精准医疗中的应用

卵巢癌是全球第三大常见的女性生殖系统恶性肿瘤,5年生存率仅为40%,早期诊断手段的缺乏和化疗耐药是目前卵巢癌诊疗面临的巨大的挑战。微流控技术(microfluidic technology)作为一种利用微芯片调控流体流动实现的集成化分析技术,具有高敏感度、高通量和低成本等显著优势,而且,该技术能在微纳尺度下模拟肿瘤微环境,有利于研究肿瘤细胞与免疫系统的交互作用。近年来微流控技术已广泛用于医学研究、药物研发、精准医疗等生命健康领域。在卵巢癌研究方面,微流控技术可用于肿瘤建模、早期肿瘤生物标志物的检测和抗肿瘤药物的筛选等,为卵巢癌早期诊断和精准治疗提供了创新视角与未来导向。

卵巢癌铂耐药及其治疗研究进展

卵巢癌是恶性程度最高的妇科恶性肿瘤之一。以铂为基础的化疗是卵巢癌治疗的重要组成部分,因此铂耐药也是卵巢癌治疗中棘手的问题。铂耐药是一个复杂的过程,涉及多种机制。本文就卵巢癌细胞铂耐药的分子机制及治疗进展作一综述,以期为该病的临床治疗提供借鉴。

Surgery in platinum-resistant recurrent epithelial ovarian carcinoma

BACKGROUND Ovarian cancer is one of the three most common malignant tumors of the female reproductive tract and ranks first in terms of mortality among gynecological tumors.Epithelial ovarian carcinoma(EOC)is the most common ovarian malignancy,accounting for 90%of all primary ovarian tumors.The clinical value of cytoreductive surgery in patients with platinum-resistant recurrent EOC remains largely unclear.AIM To evaluate the feasibility of secondary cytoreductive surgery for treating platinum-resistant recurrent EOC.METHODS This was a retrospective study of the clinical data of patients with platinumresistant EOC admitted to the Cancer Hospital of the University of Chinese Academy of Sciences between September 2012 and June 2018.Patient baseline data were obtained from clinical records.Routine follow-up of disease progression was performed as follows.CA125 assessment and physical examination were performed every 3 wk during treatment,including gynecological examination.Imaging assessment was carried out every 12 wk by B-mode ultrasound,computed tomography,or magnetic resonance imaging.The primary outcome was progression-free survival(PFS).Secondary outcomes included overall survival(OS),chemotherapy-free interval(CFI),and complications.Follow-up ended on April 15,2019.RESULTS A total of 38 patients were included.R0 resection was achieved in 25(65.8%) patients and R1/2 in 13 (34.2%). Twenty-five (65.8%) patients required organ resection. Nine(23.7%) patients had operative complications, 36 (94.7%) received chemotherapy, and five (13.2%)had targeted therapy. Median PFS and OS were 10 (95%CI: 8.27-11.73) months and 28 (95%CI:12.75-43.25) months, respectively;median CFI was 9 (95%CI: 8.06-9.94) months. R0 resection andpostoperative chemotherapy significantly prolonged PFS and OS (all P < 0.05), and R0 resectionalso significantly prolonged CFI (P < 0.05). Grade ≥ 3 complications were observed, includingrectovaginal fistula (n = 1), intestinal and urinary fistulas (n = 1), and renal failure-associated death(n = 1). Except for the patient who died after surgery, all other patients with complications weresuccessfully managed. Two patients developed intestinal obstruction and showed improvementafter conservative treatment.CONCLUSIONSecondary cytoreductive surgery is feasible for treating platinum-resistant recurrent EOC. Thesefindings provide important references for the selection of clinical therapeutic regimens.

DIFFERENTIAL EXPRESSION OF ADHESION MOLECULES (CD44,CD29,ICAM-1 AND E-CADHERIN) IN OVARIAN CANCER SK-OV-3ip1 CELLS GROWN AS MONOLAYER AND MULTICELLULAR AGGREGATES

Objective: To detect mRNA levels and expression ofCD44, CD54, CD29 and E-cadherin (E-cad) and to discuss their relationship with formation and drug resistance ofovarian cancer SKOV3ip1 multicellular aggregates.Methods: Liquid overlay system was employed to obtainmulticellular aggregates. mRNA levels and expression ofCD44, CD54, CD29 and E-cad were investigated with RTPCR and flow cytometry (FCM) respectively. Results:Compared with monolayer cells, RT-PCR results showed a decrease in CD44 mRNA level by 0.626-fold and a decrease in CD29 mRNA level by 0.792-fold in multicellularaggregates. However, an increase in CD54 mRNA level by 1.815-fold and an increase in E-cadherin mRNA level by1.344-fold were found in multicellular aggregates. Theresults revealed the downregulation of CD44 and CD29 and the upregulation of CD54 and E-cad genes activity. CD44 expression in monolayer cells and multicellular aggregates were 75.995?.046 and 50.700?.351 (%) respectively andthere was a significant decrease in multicellular aggregates (P=0.001). Compared with control cells, no expression of CD54 was detected in monolayer cells (P=0.563) but markedly elevated CD54 expression was detected in multicellular aggregates (15.780?.217) (%) (P<0.01). High expression of CD29 was seen in monolayer cells and also in multicellular aggregates with positive rates of 96.290+1.201 (%) and 92.494?.055 (%). However, the expression of CD29 in multicellular aggregates was significantly reduced (P=0.014). Also no expression of E-cadherin was found in monolayer cells compared with control cells (4.490?.283) (%) (P=0.65) while significantly increased expression in aggregates cells (17.258?5.572) (%) (P=0.003) was observed. Conclusion: Significant differences in mRNA levels and expression of CD44, CD54, CD29 and E-cadherin clearly exist between monolayer cells and multicellular aggregates, which may be associated with the formation of multicellular aggregates and its drug resistance.

MULTICELLULAR-MEDIATED RESISTANCE TO CISPLATIN AND TAXOL IN HUMAN OVARIAN CANCER SK-OV-3IP1 MULTICELLULAR AGGREGATES

Objective: To investigate the chemosensitivity of ovarian cancer SK-OV-3ip1 multicellular aggregates (MCA) to cisplatin and taxol and to explore the possible mechanisms. Methods: Liquid overlay system was employed to obtain MCA. We detected the resistance using trypan blue exclusion testing, clonogenic assay, cell cycle profiles and apoptosis with flow cytometry (FCM). Results: After cisplatin exposure, MCA cells showed nearly equal cell viability with monolayer cells (P=0.05). After 40μM cisplatin exposure for 12 h, no clone (≥50 cells) was formed, but more viable cells attached to the bottom of 24-well plate in MCA group than monolayer. Furthermore, apoptosis rate and cell cycle profiles with FCM had no significant change between MCA and monolayer cells. After taxol exposure, however, trypan blue exclusion testing demonstrated higher cell viability in MCA cells (P=0.003) and higher clone formation rate in 100-cell group than monolayer cells (0.01<P<0.025). No significant difference was found in 50-cell or 200-cell group but more viable cells in MCA group were observed. Taxol exposure caused significantly decreased apoptosis rate in MCA cells than monolayer cells (P=0.012). Taxol induced significant cell arrest at G2-M phase in monolayer cells (P=0.001), but abrogation of G2-M arrest was observed in MCA cells (P=0.002). Conclusion: Compared with monolayer cells, MCA cells from the same SK-OV-3ip1 cell line appear to be more resistant to taxol but not to cisplatin. Cell cycle redistribution and multicellular-mediated inhibition of apoptosis can partially account for the resistance.

MULTICELLULAR-MEDIATED EXPRESSION OF P-GP AND MRP AND RELATIONSHIP WITH CELL CYCLE PROFILES IN HUMAN OVARIAN CANCER SK-OV-3ip1 MULTICELLULAR AGGREGATES

Objective: To investigate the expression of P-glycoprotein (P-gp) and multidrug resistance-associated protein (MRP) and the relationship with cell cycle profiles in ovarian cancer SK-OV-3ip1 multicellular aggregates. Methods: Liquid overlay system was employed to obtain multicellular aggregates. Expression of P-gp and MRP was detected with flow cytometry (FCM). Outer, intermediate and inner cells from multicellular aggregates were collected by layer-trypsinized method. Cell cycle profiles were also analyzed by FCM. Results: Compared with control cells, no expression of P-gp and MRP was detected in monolyer cells (P=0.128 and P=0.604), but expression of P-gp and MRP in aggregate cells was significantly elevated (P<0.01). P-gp expression in every layer cells was also obviously increased (P<0.01). Furthermore, P-gp expression in every layer cells was also obviously increased (P=0.071). Tendency to increased G0–G1 phase and reduced S phase cells existed from outer through intermediate to inner layers in multicellular aggregates but with no statistical difference. Cell percentages in G2-M phase also had no difference. However, compared with monolayer cells, cells in G0–G1 phase increased and cells in S and G2-M phases lowered significantly in every layer and in the whole multicellular aggregates. Expression elevation of P-gp and MRP was consistent with increased G0–G1 percentage in aggregate cells. Conclusion: Expression of P-gp and MRP increases in cells of SK-OV-3ip1 multicellular aggregates and is consistent with increased G0–G1 percentage, which implies the possible relationship between them and the possible role in multicellular-mediated drug resistance.

Toxicity of Paclitaxel and Cisplatin in Combination for Advanced Ovarian Cancer

Objective:To evaluate the toxicity of paclitaxel and cisplatin combination in patients with advanced ovarian cancer.Methods:A retrospective review was performed on patients with stage Ⅲ or stage Ⅳ ovarian cancer treated in QiLu hospital between October 1996 and June 1999 Results:26 patients received adjuvant paclitaxel and cisplatin chemotherapy.The significant toxicity included:anemia 7/26(27%),thrombocytopenia 10/26(38%),neutropenia 19/26(73%),nausea or vomiting 24/26(92%) and neurotoxicity 11/26(42%).No patient delayed.No patient died during treatment.Conclusion:The dosages of primary paclitaxel and cisplatin chemotherapy is reasonably well tolerated for patients with stage Ⅲ or Ⅳ ovarian cancer.

异丙酚对卵巢癌进展和顺铂敏感性的影响及机制

目的探讨异丙酚对卵巢癌进展及顺铂(DDP)敏感性的影响及机制。方法取对数生长期的卵巢癌细胞A2780和耐DDP卵巢癌细胞A2780/DDP,分别与异丙酚(0、1、5、10及20 mg/L)和DDP(0、5、10、20、40及80μmol/L)进行孵育,采用CCK-8法观察A2780和A2780/DDP细胞存活率;取对数生长期的A2780和A2780/DDP细胞分为Control组(等量培养基)、异丙酚组(10 mg/L异丙酚)、DDP组(10μmol/L DDP)、异丙酚+DDP组(10 mg/L异丙酚+10μmol/L DDP),克隆形成实验观察细胞克隆数,流式细胞仪检测细胞凋亡,Western blot检测凋亡蛋白B细胞淋巴瘤-XL(Bcl-xl)单克隆抗体、细胞凋亡调节因子(Bim)及活化半胱氨酸蛋白酶-3(cleaved caspase-3)表达,Transwell检测各组A2780和A2780/DDP细胞的侵袭;裸鼠移植瘤实验观察各组肿瘤生长情况。结果A2780、A2780/DDP细胞活力随异丙酚和DDP浓度升高均下降,A2780/DDP细胞系半抑制浓度(IC50)均高于A2780细胞系(P<0.05);与Control组相比,异丙酚组和DDP组A2780、A2780/DDP细胞系细胞活力、细胞克隆数、细胞侵袭率及Bcl-xl表达均下降,细胞凋亡率、Bim和cleaved caspase-3表达均上升(P<0.05);与DDP组相比,异丙酚+DDP组A2780、A2780/DDP细胞系细胞活力、细胞克隆数、细胞侵袭率及Bcl-xl表达均下降,细胞凋亡率、Bim及cleaved caspase-3表达均上升(P<0.05);异丙酚组和DDP组裸鼠肿瘤质量和肿瘤体积均较Control组和DDP组下降(P<0.05)。结论异丙酚可增强DDP对卵巢癌细胞生长的抑制作用,其机制可能与增加DDP细胞毒性、细胞凋亡、DDP敏感性及抑制肿瘤细胞侵袭行为有关。

卵巢癌中PARP抑制剂的耐药机制及提高其敏感性的联合治疗策略

卵巢癌是致死率最高的妇科恶性肿瘤。多腺苷二磷酸核糖聚合酶抑制剂[poly(ADP-ribose)polymerase inhibitor,PARPi]通过酶促抑制和PARP“捕获”使DNA单链断裂修复受损,从而在具有乳腺癌相关基因(breast cancer-related gene,BRCA)缺陷或同源重组修复缺陷的肿瘤细胞中通过合成致死效应推动其在卵巢癌维持治疗上的应用。但PARPi的耐药性成为PARPi长期应用的障碍。目前研究显示,PARPi获得性耐药的机制包括同源重组修复恢复、DNA复制叉保护、PARP“捕获”减少及药物外排增加等。通过针对特定的耐药机制,目前正在研究的主要的联合治疗策略有PARPi与抗血管生成剂、细胞周期检查点蛋白抑制剂、信号通路抑制剂、免疫治疗和表观遗传修饰剂等联合,可能有助于预防和对抗PARPi的耐药性,从而提高PARPi的敏感性和抗肿瘤作用。

卵巢癌对聚腺苷二磷酸核糖聚合酶抑制剂耐药机制的研究进展

聚腺苷二磷酸核糖聚合酶(PARP)抑制剂类药物的问世是近年来肿瘤靶向治疗领域中的重要突破之一,其对于卵巢癌的治疗效果颇为显著。然而,一部分患者对于PARP抑制剂的治疗并不敏感,这种耐药现象限制了其在卵巢癌中的应用。探讨PARP抑制剂耐药机制、寻找克服耐药策略成为进一步扩大PARP抑制剂获益人群的迫切需求。现有研究表明,卵巢癌对PARP抑制剂耐药的主要机制有同源重组修复活性恢复、相关信号通路因子表达异常、药物外排作用和复制叉稳定性改变等。本文将就卵巢癌对PARP抑制剂耐药机制的研究进展作一综述,旨在为PARP抑制剂在临床中的合理应用提供理论依据,并对克服耐药策略的探索提供参考思路。

铁死亡在卵巢癌中的研究进展

铁死亡是一种不同于自噬、凋亡和坏死的新型细胞死亡方式,通过细胞铁过载和脂质过氧化启动。近年来,越来越多的研究探索铁死亡相关机制在卵巢癌中的作用,发现改变卵巢癌细胞内铁和脂质的代谢,以及P53、Yes相关蛋白(Yes-associated protein,YAP)和基于PDZ结合基序的转录共激活因子(transcriptional co-activator with PDZbinding motif,TAZ)的表达可以调控癌细胞铁死亡,进而影响卵巢癌进展。研究还证实铁死亡不仅可以提高卵巢癌细胞对铂类药物的敏感性,增强化疗效果,而且可以改善卵巢癌细胞对多腺苷二磷酸核糖聚合酶[poly(ADP-ribose)polymerase,PARP]抑制剂的耐药性,提高卵巢癌患者PARP抑制剂治疗的临床获益,而PARP抑制剂与免疫治疗又能促进卵巢癌细胞铁死亡,表明铁死亡与化疗、PARP抑制剂和免疫治疗在抑制卵巢癌细胞生长方面具有协同作用,铁死亡可能成为未来卵巢癌治疗的一个新靶点。

患者报告结局量表在卵巢癌化疗中的应用价值

卵巢癌是致死率第一位的女性生殖系统恶性肿瘤,晚期卵巢癌的标准治疗为恶性肿瘤细胞减灭术联合化疗及靶向治疗。既往患者在化疗中及化疗后的不良反应主要采用临床医生报告结局(Clinician-Reported Outcome,ClinRO)进行评估。近年来,临床实践中一种新兴且可靠的患者健康状况评估方法——患者报告结局(Patient-Reported Outcome,PRO)日渐得到广泛关注。目前常用的PRO量表包括PRO-不良反应事件评价标准(Common Terminology Criteria for Adverse Events,CTCAE)、MDASI(M.D.Anderson Symptom Inventory)和QLQ-C30等,能够对患者健康状况进行多方面评估,监测临床症状,干预临床治疗和评估治疗方案,改善患者预后。但是,目前的PRO量表中部分项目的评估效果尚未得到有效验证,缺乏对于特定患者群体的队列研究。未来仍需进一步改进PRO量表和相关研究内容,以期获得更好的效果。

人增殖抑制基因(HSG)对肿瘤细胞系化疗敏感性的作用

目的:将人增殖抑制基因 (hHSG)用电子穿孔的转基因方式转染到体外培养的人肿瘤细胞系中,观察hHSG基因对内源性hHSG表达水平不同的肿瘤细胞系的化疗敏感性的影响。方法:首先用免疫组化方法检测不同组织来源的肿瘤细胞系中hHSG的表达水平,然后选择内源性hHSG表达水平较低的肺腺癌 (A549 )和内源性hHSG表达水平较高的宫颈癌(HeLaS3)细胞系,用电穿孔方法转染含有hHSG的真核表达载体 (pEGFP hHSG) 24h后,加入放线菌酮(CHX),采用细胞计数、MTT法观察hHSG对肿瘤细胞增殖抑制作用及对CHX的化疗敏感性的影响。结果:hHSG在不同组织来源的肿瘤细胞系都有不同程度的表达, pEGFP hHSG转染到两种内源性hHSG表达水平不同的肿瘤细胞系后,这两种肿瘤细胞的生长增殖都明显受到抑制,同时外源性的hHSG也增强了这些肿瘤细胞系对CHX的敏感性。结论:外源性hHSG可不依赖其内源性表达水平而抑制肿瘤细胞的增殖,与CHX并用可增强肿瘤细胞对CHX的敏感性,具有协同作用。

雄黄对荷人卵巢癌裸鼠移植瘤细胞凋亡的基础研究

目的:观察中药雄黄诱导卵巢癌细胞凋亡及血管生成的作用。方法:应用流式细胞术、荧光显微镜、透射电子显微镜和免疫组织化学等技术,以细胞凋亡和VEGF为主要观测指标,观察中药雄黄对荷人卵巢癌裸鼠移植瘤抗肿瘤作用。结果:雄黄可诱导荷人卵巢癌裸鼠移植瘤细胞凋亡,抑制荷瘤裸鼠肿瘤的生长,阻止血管生成抑制细胞DNA的合成,并可延长小鼠存活时间。结论:雄黄可通过诱导卵巢癌细胞凋亡,阻止血管生成,抑制细胞DNA的合成等多种途径发挥抗肿瘤作用,具有广阔的应用前景。