NSCLC患者外周血淋巴细胞抗癌药敏试验与化疗疗效的相关性

目的 研究非小细胞肺癌(NSCLC)患者外周血淋巴细胞(PBL)抗癌药敏试验与化疗疗效的相关性,为临床肿瘤个体化化疗提供依据.方法 52例NSCLC患者PBL接受四甲基偶氮唑蓝(MTT)药敏试验,根据结果分为敏感组和不敏感组.敏感组根据药敏结果化疗,不敏感组采用常规方案化疗,观察各组临床近期疗效;其中29例初治患者化疗2周期后再次取PBL接受MTT药敏试验.结果 52例患者PBL对7种化疗药物的体外敏感性顺序依次为:长春瑞宾、吉西他滨、泰索帝、紫杉醇、丝裂霉素、长春地辛和顺铂,与临床实践基本一致.敏感组和不敏感组近期临床有效率分别为73.68%(14/19)和6.45%(2/31),差异有显著性(P＜0.01);29例初治患者PBL在化疗前后总敏感率分别为28.64%(110/348)和22.99%(80/348),差异有显著性(P＜0.05).结论 PBL抗癌药敏试验有助于指导临床肿瘤个体化化疗和预测化疗疗效.化疗后PBL对化疗药物的敏感性有不同程度下降.

Relationship between Sensitivity of Peripheral Blood Lymphocytes to Chemotherapy and Chemotherapeutic Effect in Patients with Non-Small Cell Lung Cancers

Objectives To explore the relationship between the sensitivity of peripheral blood lymphocytes (PBL) to chemotherapy and chemotherapeutic effects and to provide the data for individualized chemotherapy in patients with non-small cell lung cancer (NSCLC). Methods Fifty-two patients with NSCLC were divided into sensitive group and resistive group according to the degree of sensitivity of PBL to chemotherapy determined by MTT assay. The patients in the sensitive group were treated according to the result of MTT assay. The patients in the resistive group were treated by the routine chemotherapy. Short-term responses to the chemotherapy were evaluated in 50 patients, among whom, 29 patients who accepted the first chemotherapy received again MTT assay of PBL after 2 cycles of chemotherapy. Results Vinorelbine, gemcitabine, taxotere, paclitaxel, mitomycin, vindesine and cisplatin were arranged in the order of PBL sensitivity to anti-cancer drugs in these 52 cases, which was consistent with NSCLC sensitivity to these drugs observed by clinical practice. The short-term response rates in the sensitive group and resistive group were 73.68%(14/19) and 6.45%(2/31), respectively. There was significantly difference in the response rate between both the groups (P<0.01). Chemosensitivity of PBL in 29 patients who accepted no chemotherapy previously was significantly higher (28.64%, 110/348) before the chemotherapy than that (22.99%,80/348) after the chemotherapy (P<0.05). Conclusion The sensitivity of PBL to anti-cancer drugs is helpful to individualized chemotherapy and prediction of the curative effect in patients with NSCLC. The sensitivity of PBL to the drugs descends to different extent after the chemotherapy.