乳腺癌对化疗药物的体外敏感性及其与临床

 目的　探讨肿瘤组织对化疗药物的体外敏感性与乳腺癌患者年龄、病理分型、分级及淋巴结转移情况的关系。方法　收集60例手术切除新鲜乳腺癌标本或活检标本，采用组织培养-终点染色-计算机图像分析（TECIA）法，检测癌组织对7种常用抗癌药物5-氟尿嘧啶（5-Fu）、顺铂（DDP）、长春瑞滨（NVB）、紫杉醇（TAX）、多西紫杉醇（TAT）、多柔比星（ADM）、表柔比星（EADM）的敏感性。结果　60例乳腺癌标本中有31.67 %的标本对所有7种被测化疗药物均不敏感。在所有病例中，对特定药物的敏感率由高到低依次为EADM（60.00 %，36／60）、NVB（53.33 %，32／60）、DDP／TAT（36.61 %，22／60）、TAX（30.00 %，18／60）、5-Fu（26.67 %，16／60）、ADM（16.67 %，10／60）。浸润性乳腺癌比非浸润性的敏感率高（74.47 %比46.15 %，P <0.05），Ⅲ级比Ⅰ、Ⅱ级敏感率高（90.91 %比54.55 %， 90.91 %比55.56 %，P均<0.01）。不同年龄的3个组之间、有和无淋巴结转移两组之间差异均无统计学意义（P >0.05）。结论　乳腺癌组织可能对EADM、NVB、TAT敏感率较高，TECIA法对个体化化疗具有重要参考价值。

Chemosensitivity in vitro and its correlation with clinico-pathological parameters of patients with breast cancer

Objective　To detect any association between chemosensitivity of tumor in vitro and clinico-pathological characteristics of patients with breast cancer, such as age, pathological type, pathological grade, as well as local lymph nodal status. Methods　Sixty patients with breast cancer were tested with tissue culture-end point staining-computer image analysis(TECIA) after resection of the primary lesion or biopsy. Their chemosensitivity to seven common anticancer drugs were evaluated, which were fluorouracil(5-Fu), vinorelbine(NVB), cisplatin(DDP), paclitaxel(TAX), docetaxel(TAT), doxorubicin(ADM) and epirubicin(EADM). Results　31.67 % of the total 60 specimens were resistant to all of 7 drugs. The sensitive rate of the tissues to a specific drugs was 60.00 % (36/60) for EADM, 54.00 %(32/60) for NVB, 36.00 %(22/60) for DDP or TAT, 30.00 %(18/60) for TAX, 26.00 %(16/60) for 5-Fu and 16.00 %(10/60) for ADM in turn. The sensitive rate of invasive carcinoma group was higher than non- invasive carcinoma group(74.47 % vs 46.15 %, Ｐ <0.05), and grade Ⅲ group higher than grade Ⅰ or grade Ⅱ group (90.91 % vs 54.55 %, 90.91 % vs 55.56 %, Ｐ <0.01). The differences of sensitive rates among three different age groups and between two groups with/ without lymph nodal metastasis were not significant statistically(Ｐ > 0.05). Conclusion　The total sensentive rate of breast cancer might be relatively high to EADM, NVB and TAT, and TECIA could be an important reference for clinical individual chemotherapy.