恶性肿瘤患者化疗敏感性筛选的临床意义

目的 研究不同种类的恶性肿瘤患者对22种化疗药物的敏感性，筛选敏感性化疗药物，为临床化疗用药提供参考。方法 182例患者的恶性肿瘤细胞分别用22种化疗药物作用24～48h，药物依据临床血浆高峰浓度（PPC）配制；采用MTT法检测肿瘤细胞抑制率，评价药物敏感性。结果 在药物浓度1.0PPC和细胞浓度3～5×105／ml的测试条件下，7种不同化疗药物对40例恶性神经胶质瘤细胞的抑制率均不同，其中BCNU、TMZ、VM26的抑制率较高，7种药物的敏感率由高到低依次为BCNU＞TMZ＞DDP＞VM26＞VCR＞CBP＞VP16；13种化疗药物对59例卵巢癌细胞的抑制率不同，其敏感率由高到低依次为L OHP＞TPT＞TAX＞ADM＞TXT＞GEM＞CBP＞CTX＞IFO＞LBP＞DDP＞PYM＞EADM；6 种化疗药物对19例骨及软组织肿瘤细胞的抑制率相近，MTX和TAX的抑制率达到40％以上，药物敏感率由高到低依次为ADM＞MTX＞IFO＞DDP＞TAX＞DTIC；8种药物对64例头颈部肿瘤细胞的抑制率不同，药物敏感率由高到低依次为PYM＞CTX＞BLM＞DDP＞5 FU＞VP16＞VCR＞TAX。结论 肿瘤患者对化疗药物的敏感性存在明显的个体差异，同一种药物对不同恶性肿瘤细胞作用的抑制率均不同，不同药物的敏感率在不同肿瘤中的比例均不同。化疗前对不同恶性肿瘤患者进行个体化疗敏感性筛选是必要的，可以有效避免盲目用药，减少毒副作用，提高疗效和生存质量。

Clinical significance of chemosensitivity screening in malignant tumor patients

Objective To investigate the sensitivity of 22 kinds of chemotherapeutic drugs in patients bearing different mall- grant tumors, in order to select proper drugs and provide reference for clinical application. Methods Malignant tumor cells of 182 samples were affected by 22 kinds of chemotherapeutic drugs for 24-48 hours on the basis of clinical peak plasma concentation（PPC） , and then the resistance rate and investigate the chemosensivity of antitumor drugs were tested by MTT assay. Results The resistance rate of 40 varieties of spongioblastoma cells affected by 7 different kinds of chemotherapeutic drugs was different in the condition of 1.0 PPC and 3-5 x 105/ml cell concentration. BCNU, TMZ and VM26 of which have higher resistance rate of malignant tumors than the other chemotherapeutic drugs. The 7 different kinds of chemotherapeutic drugs classified in susceptibility rate from high to low was BC- NU 〉 TMZ 〉 DDP 〉 VM26 〉 VCR 〉 CBP 〉 VP16. The resistance rate of 59 varieties of oophoroma cells affected by 13 different kinds of chemotherapeutic drugs was different, and the susceptibility rate of these 13 different chemotherapeutic drugs classified from high to low was L-OHP 〉 TPT 〉 TAX 〉 ADM 〉 TXT 〉 GEM 〉 CBP 〉 CTX 〉 IFO 〉 LBP 〉 DDP 〉 PYM 〉 EADM. The resistance rate of 19 varieties of bone and soft tissue tumor cells affected by 6 different kinds of chemotherapeutic drugs was similarity, of which MTX and TAX have the resistance rate more than 40%. These chemotherapeutic drugs classified in susceptibility rate from high to low was ADM 〉 MTX 〉 IFO 〉 DDP 〉 TAX 〉 DTIC. The resistance rate of 64 varieties of head and neck cancer cells affected by 8 different kinds of chemothera- peutic drugs was different, and the susceptibility rate of these chemotherapeutic drugs classified from high to low was PYM 〉 CTX 〉 BLM 〉 DDP 〉 5-FU 〉 VP16 〉 VCR 〉 TAX. Conclusion Malignant tumor patients have significant individual differences to chemo- therapeutic drugs in ehemoseusitivity. The individual screening of chemosensitivity to different kinds of cancer patients before chemo- therapy application is absolutely essential. It can decrease toxic reaction by avoiding blindly using chemotherapeutic drugs and increase therapeutic effect and survival quality. Chemotherapy under the guidance of chemosensitivity test in vitro may improve the therapeuticeffect and help clinician to choose reasonable chemotherapy drugs for patients individually.