老年胃癌原发灶与淋巴结转移灶体外化疗药敏性的差异及意义

目的比较老年胃癌原发灶与淋巴结转移灶体外化疗药敏性的差异并探讨其意义。方法对35例伴淋巴结转移的老年胃癌患者(≥60岁)和31例对照组胃癌患者(<60岁)的肿瘤原发灶、淋巴结转移灶进行MTT法原代细胞培养化疗药敏性实验,比较不同病灶肿瘤细胞对11种化疗药物敏感性的差异。结果老年组患者有6/11种化疗药物对原发灶、淋巴结转移灶的肿瘤细胞抑制率不同(均P<0.05),其中L-OHP、CDDP、MMC、THP对转移淋巴结肿瘤细胞抑制率明显低于原发灶(均P<0.05),PTX、EPI对原发灶肿瘤细胞抑制率明显低于淋巴结转移灶(均P<0.05)。与对照组比较,原发灶5-FU、PTX、EPI、MMC、MTX对老年患者肿瘤细胞抑制率低于对照组(均P<0.05);转移灶中5-FU、L-OHP、CDDP对老年患者肿瘤细胞抑制率较对照组降低(均P<0.05)。结论老年胃癌淋巴结转移灶对化疗药物敏感性与原发灶及对照组比较均存在异质性;老年肿瘤原发灶的化疗药敏性结果不能准确反映转移淋巴结的耐药性。

Chemosensitivity of lymph node metastases and primary tumor of gastric carcinoma in elderly patients

Objective To investigate the chemosensitivity of lymph node metastases（LNMs） and primary tumors（PT） of gastric carcinoma in elderly patients.Methods In vitro MTT assay was performed in surgical specimens of PT and LNMs from 35 elderly（≥60） patients with gastric cancer and 31 younger patients（60） as control group.The results were then compared with response to 11 antitumor drugs.Results There was significantly different chemosensitivity to antitumor drugs between PT and LNMs in elderly patients.The inhibition rates of tumor cells in LNMs for L-OHP,CDDP,MMC and THP were lower than those in PT（all P0.05）;while the inhibition rates for PTX and eADM were higher in LNMs than in PT（both P0.05）.There was a significantly difference in inhibition rates of tumor cells between elderly and control groups for 5-FU,PTX,eADM,MMC and MTX in PT（all P0.05）;in LNMs the inhibition rates for 5-FU,L-OHP,CDDP in elderly were lower than in control group（all P0.05）.Conclusions There are differences in chemosensitivity to antitumor drugs between metastatic lymph nodes and primary tumors in elderly gastric cancer patients,which indicates that the chemosensitivity of PT to drugs response may not give a good indication for the chemosensitivity of metastatic lesions.