乳腺癌的TECIA法药敏试验及其临床应用价值

目的探讨组织培养-终点染色计算机图像分析（TECIA）法体外肿瘤药敏试验对乳腺癌化疗的临床应用价值。方法选取2005年9月至2008年9月本院手术的46例乳腺癌标本，采用TECIA法进行化疗药物敏感性的体外检测。所测药物为乳腺癌常用化疗药物紫杉醇（PTX）、诺维本（NVB）、多柔比星（ADM）、氨甲喋呤（MTX）、5-氟脲嘧啶（5-FU）、顺铂（DDP）及联合化疗TA（PTX＋ADM）、NP（NVB＋DDP）、CAF（CTX＋ADM＋5-FU）、CMF（CTx＋MTX＋5-FU）方案。化疗药物敏感性差异的比较，采用多个样本率的χ^2检验。结果46例乳腺癌对化疗药物的敏感性为：PTX60．9％（28／46）、NVB58．7％（27／46）、ADM56．5％（27／46）、MTX37．0％（17／46）、5-FU 34．8％（16／46）、DDP26．1％（12／46）；PTX、NVB、ADM、MTX之间及5-FU和DDP之间比较，敏感率差异均无统计学意义（χ^2=6．724，P=0．081；χ^2=0．821，P=0．365），PTX、NVB比5-FU、DDP的敏感率高，其差异有统计学意义（P〈0．003）；TA、NP、CAF和CMF方案的敏感率分别为71．7％（33／46）、67．4％（31／46）、45．7%（21／46）、39．1％（18／46），但TA与NP方案、CAF与CMF方案比较，差异无统计学意义（P〉0．007）；TA和NP方案比CAF和CMF方案的敏感率高，其差异有统计学意义（P〈0．007）。PTX、NVB及含有此类药物的联合化疗方案的敏感性较高，化疗药物敏感性存在个体差异。结论TECIA法体外肿瘤药敏试验在乳腺癌的化疗用药方面具有指导意义。

Study on drug sensitivity test in breast cancer and its clinical value

Objective To explore in vitro chemosensitivity of breast cancer with TECIA （tissue culture-end point staining-computer image analysis） and its clinic value in chemotherapy of breast cancer. Methods Forty-six specimens of breast cancer were selected from the patients who underwent breast cancer surgery from September 2005 to September 2008 in our hospital and were used for evaluating the chemosensitivity of breast cancer cells with TECIA. The drugs tested were the drugs commonly used for breast cancer including paclitaxol （PTX）, navelbine （NVB）, （adriamycin）ADM, methotrexate （MTX）, （5-fluorouracil）5-FU, （cisplatin） DDP, and combined regimens as TA （PTX ＋ ADM）, NP （NVB＋ DDP）, CAF（CTX＋ ADM＋5- FU） and CMF（CTX＋ MTX＋ 5-FU）. The drug sensitivity difference was compared using Chi square test. Results In the 46 specimens of breast cancer, the sensitivity to PTX was 60.9% （28/46）, to NVB 58.7% （27/46）, to ADM 56.5% （27/46）, to MTX 37.0% （17/46）, to 5-FU 34.8% （16/46）and toDDP 26.1% （12/46）. There was no difference in PTX,NVB,ADM and MTX. Also, there was no difference in 5 FU and DDP（χ^2=6. 724,P=0. 081;χ^2 =0. 821,P=0. 365）. The sensitivity of PTX and NVB was higher than that of MTX,5 FU and DDP（P〈0. 003）. The sensitivity to TA, NP,CAF and CMF was 71.7%（33/46）, 67. 4%（31/46）, 45. 7% （21/46） and 39. 1% （18/46）, respectively. There was no difference between TA and NP and between CAF and CMF （P〉0. 007）. The sensitivity of TA and NP was higher than that of CAF and CMF, with statistical difference （P〈0. 007）. The sensitivity of PTX and NVB or chemotherapy regimens with PTX and NVB was higher. There was individual difference in the sensitivity of chemotherapy drugs. Conclusion In vitro chemosensitivity of breast cancer with TECIA is of guiding significance in clinics.