氟尿嘧啶和奥沙利铂在胃癌中的体外化疗敏感性检测

目的：探讨氟尿嘧啶（5-FU）和奥沙利铂（OX）在胃癌中的体外化疗敏感性。方法：纳入病理确诊并自愿接受检测的胃癌患者,采用ATP肿瘤化疗敏感性检测法（ ATP-TCA）检测新鲜手术标本对5-FU和OX的体外化疗敏感性。结果：纳入27例,男性21例、女性6例,中位年龄60．0岁,远侧部胃癌14例（51．9%）,低分化及印戒细胞癌共20例（74．1%）,TNM Ⅲ＋Ⅳ期21例（77．8%）。 ATP-TCA检测显示5-FU＋OX在各药物浓度的肿瘤生长抑制率均显著高于5-FU或OX（P〈0．05）,5-FU＋OX的抑制曲线下面积显著高于5-FU或OX（P〈0．05）；而其化疗敏感指数、IC90和IC50显著低于5-FU或OX （ P〈0．05）。5-FU、OX和5-FU＋OX的体外化疗敏感性依次为18．5%、14．8%和55．6%,5-FU＋OX的敏感性显著高于5-FU或OX（5-FU＋OX vs．5-FU：P=0．001和5-FU＋OX vs． OX：P=0．003）。 Logistic回归分析显示5-FU的敏感性与临床病理特征无显著相关性,而OX和5-FU＋OX的敏感性分别与Borrmann分型（OR=7．570,P=0．025）和肿瘤位置（OR=3．427,P=0．019）有显著相关性。结论：5-FU＋OX在胃癌中显示出较高的体外化疗敏感性,但其与体内疗效的相关性有待进一步临床观察。

In Vitro Chemosensitivity of Fluorouracil and Oxaliplatin in Gastric Cancer

Objective： To investigate the in vitro chemosensitivity of fluorouracil （5-FU） and oxaliplatin （OX） in gastric cancer. Methods：Patients with histologically confirmed gastric cancer were enrolled for the study. All patients a-greed to the chemosensitivity test of their resected tumors and gave informed consent. Adenosine triphosphate tumor chemo-sensitivity assay （ ATP-TCA） was performed to determine the chemosensitivity of 5-FU and OX in resected gastric cancer specimens. Results：Twenty-seven patients with a median age of 60. 0 were enrolled, including 21 males and 6 females. The tumors were located in the lower part of the stomach in 14 cases, 20 cases were poorly differentiated or signet-ring cell carcinoma and 21 cases were in late TNM stage. ATP-TCA assay showed that the tumor growth inhibition rates of 5-FU＋OX were significantly higher than those of 5-FU or OX at each test drug concentration （ P〈0. 05 ）; correspondingly, the area under the curve of 5-FU＋OX was significantly higher than those of 5-FU or OX （P〈0. 05）, whereas their chemosen-sitivity index, IC90 and IC50 were significantly lower than those of 5-FU or OX （P〈0. 05）. The chemosensitivity rates of 5-FU, OX and 5-FU＋OX were 18. 5%, 14. 8% and 55. 6%, respectively; chemosensitivity of 5-FU＋OX was signifi-cantly higher than that of 5-FU or OX （5-FU＋OX vs. 5-FU：P=0. 001 and 5-FU＋OX vs. OX：P=0. 003）. Logistic re-gression analysis indicated that the chemosensitivity of 5-FU was not significantly correlated with any clinicopathological characteristics;however, the chemosensitivity of OX and 5-FU＋OX was significantly correlated with Borrmann type （ OR=7. 570, P=0. 025） and tumor location （OR=3. 427, P=0. 019）, respectively. Conclusion：5-FU＋OX showed high in vitro chemosensitivity in gastric cancer, and may be worthy of further exploration to see its correlation with in vivo efficacy.