三维组织培养药物敏感性检测技术在胃癌术后个体化化疗中的应用研究

目的 研究三维组织培养药物敏感性检测（three—dimensional histocuhure drugresponseassay。TDHDRA）技术在指导胃癌术后个体化化疗中的临床价值。方法将147例胃癌患者随机分为肿瘤药敏组和经验化疗组。肿瘤药敏组应用TDHDRA技术，检测5-氟尿嘧啶（5-FU）、多西他赛（DTX）、顺铂（DDP）、紫杉醇（TXT）、奥沙利铂（OXA）、表阿霉素（EADM）、伊立替康（CPT-11）这7种单药和DTx＋DDPI＋（5-FU）、EADM＋DDP＋（5-FU）、DDP＋（5-FU）、OXA＋（5-FU）、CPT-11＋（5-FU）这5组联合用药对胃癌组织的抑制率，计算胃癌组织对药物的敏感率，并通过随访，记录两组的无进展生存期（progressionfreesurvival。PFS）和总生存期（overallsurvival，os），比较两组的化疗效果。结果单药中5-FU对胃癌组织的抑制率和敏感率最高，分别为（44．8±12．1）％和57．9％；联合用药中DTX＋DDP＋（5-FU）组合对胃癌组织的抑制率、敏感率最高，分别为（64．3±15．6）％、75.4％。经验化疗组与肿瘤药敏组分别有16例、7例出现复发转移；肿瘤药敏组中位PFS（162d）显著高于经验化疗组（84d），且差异有统计学意义（P〈0．05）；肿瘤药敏组OS（476d）虽高于经验化疗组（392d），但两组差异无统计学意义（P〉0．05）。结论TDHDRA技术检测结果符合临床实际，在指导胃癌术后个体化化疗中有很好的临床价值。

The application research of three-dimensional histoculture drug response assay in individuation chemotherapy of gastric carcinoma postoperative

Objective To investigate the clinical value of three-dimensional histocuhure drug response assay （TDHDRA） in guiding individual chemotherapy of gastric cancer patients. Methods The 147 cases patients with gastric cancer were randomly divided into tumor chemosensitivity group and empirically chemotherapy group. The inhibition rate of 5- fluorouracil（5-FU）, eisplafin（DDP）, oxaliplatin（OXA）, doeetaxel （DTX）, paclitaxel（TXT）, irinoteean（CPI-111）, epirubiein（EADM） and DTX ＋ DDP ＋（5-FU）, EADM ＋ DDP ＋ （5- FU）, DDP ＋ （5-FU）, OXA ＋ （5-FU）, CPT-11 ＋ （5-FU） to gastric cancer, and the sensitivity of gastric cancer to the drugs were detected by TDHDRA. Those patients were follow-up and recorded their progression-free survival （PFS） and overall survival （OS）. The effect of chemotherapy between two groups were compared. Results The inhibition rate （44.8±12.1）%] and sensitivity（57.9%） of 5-FU were the highest among single agents. The inhibition rate （64.3±15.6）%] and sensitivity（75.4%） of DTX ＋ DDP ＋ （5-FU） to gastric cancer were the highest among combined regimens. The recurrence patients in tumor chemosensitivity group and empirically chemotherapy group were respectively 16 cases and 7 cases. The PFS of tumor chemosensitivity group （162 d） was significantly higher than the empirically chemotherapy group（84 d）, and the difference had statistical signifieane（P〈 0.05）. The OS of tumor chemosensifivity group （476 d） was higher than that of the empirically chemotherapy group（392 d）, but there was no significant difference between the two groups（P〉 0.05）. Conclusion The results of TDHDRA are coincidence with clinical practice and have good clinical value in guiding individual chemotherapy of gastric cancer.