ATP-TCA检测乳腺癌细胞对体外化疗药物敏感性的研究

目的 ATP-TCA检测乳腺癌患者肿瘤细胞对化疗药物的敏感性,评价本方法指导乳腺癌个体化疗的可行性。方法 35例行乳腺癌改良根治术患者纳入本研究,术中取新鲜无菌肿瘤组织,进行原代细胞培养,分别加入9种化疗药物,采用ATP-TCA测定药物对肿瘤细胞的抑制情况。结果 35例标本中32例完成药敏检测,标本的可评价率为91.4%。患者对化疗药物的体外敏感性存在个体差异,乳腺癌细胞对ADM最敏感,体外有效率达到81.2%(26/32),其余依次为DOC68.8%(22/32)、TAX59.4%(19/32)、NVB43.8%(14/32)及5-Fu 34.4%(11/32)、DDP31.2%(10/32)、GEM25%(8/32)。而对于MTX及Vp-16,耐药个体占很大部分,体外有效率分别为0(0/32)和12.5%(4/32)。结论乳腺癌体外化疗药物敏感性检测结果以蒽环类和紫杉类有效率最高,ATP-TCA检测的开展可能为临床化疗用药的个体化实施提供实验依据。

Chemosensitivity in Vitro by ATP - TPC in Patients with Breast Cancer

Objective To measure the appropriate chemotherapeutic agents on breast cancer cells in vitro by ATP-TCA and to evaluate the possibility of individual chemotherapy of breast cancer patients.Methods The study included 35 women with breast cancer who were subjected to modified radical mastectomy.All patients were initially treated,without adjuvant chemotherapy and radiotherapy.Tumor tissue were cultured with 9 kinds of chemotherapeutic agents at respective peak plasma concentration with three repeats for 3-5 days.The inhibition rate of the samples was measured by ATP bioluminescence assay.Results 32 of 35 assays completed successfully with ATP-TCA,with a evaluability rate of 91.4%.The assay results suggested that 32 specimens from different breast cancer patients responded to chemotherapeutic drugs with individualized profiles.The most effective drug in the experiment was Adriamycin,and then Docetaxel,Paclitaxel,Vinorelbine,5-Fluorouracil,Cis-platinum and Gemcitabine,the rates of chemosensitivity of which were 81.2%,68.8%,59.4%,43.8%,34.4%,31.2% and 25% respectively.While Methotrexate and Etoposide(VP 16) were almost weakly active or resistive(0&12.5%).Conclusion The anthracycline and taxane chemotherapeutic program has a better consistence of breast cancer in vitro chemosensitivity test.The vitro susceptibility test may provide the experimental basis for the implementation of the individual chemotherapeutic drugs.