消化道肿瘤淋巴结转移灶体外化疗药敏性的变化及其意义

目的：探讨消化道肿瘤淋巴结转移灶化疗药敏性的变化及其意义。方法： 对40例伴淋巴结转移的胃癌和结直肠癌的原发灶及淋巴结转移灶进行MTT法原代细胞培养化疗药敏性试验, 比较两种病灶对9种化疗药物敏感性的差异。结果：7/9种化疗药物对原发灶和淋巴结转移灶的肿瘤细胞抑制率有差异 (均为P<0.05), 其中HCPT，LOHP，CDDP对转移淋巴结细胞抑制率明显低于原发灶(均为P<0.05), eADM,VP-16,THP,MMC对原发灶肿瘤细胞抑制率明显低于淋巴结转移灶(均为P<0.05)。5-FU，HCPT，LOHP，THP对原发灶和转移淋巴结的肿瘤细胞抑制率呈正相关(r=0.4142~0.5712, 均P<0.05),仅5-FU对两种病灶肿瘤细胞的抑制率无统计学差异(P>0.05)。 结论消化道肿瘤淋巴结转移灶对化疗药物敏感性与原发灶之间存在异质性；肿瘤原发灶对化疗药物敏感性并不能完全反映转移淋巴结的化疗耐药性。

Comparison of chemosensitivity in gastrointestinal cancers lymph node metastases and the primary tumors in vitro

Objective:To investigate the different chemosensitivity of lymph node metastases compared to the primary tumor in gastrointestinal cancers. Methods:In vitro MTT colorimetric assay was performed on surgical specimens of primary tumors(PTs) and lymph node metastases(LNMs) form 40 gastrointestinal cancer patients. The Results: were then compared with response to 9 antitumor drugs. Results:There was significantly different chemosensitivity to antitumor drugs between PTs and LNMs. The inhibition rates of tumor cells in LNMs for HCPT, L-OHP and CDDP were lower than those in PTs (all P<0.05); whereas the inhibition rate of tumor cell in LNMs for eADM, VP-16,and THP were higher than those in PTs (all P<0.05); howevre the chemosensitivity for 5-FU and PTX was equivalent in the two groups(all P>0.05). There was a significantly positive correlation between the inhibition rates of PTs and LNMs for 5-FU, HCPT, L-OHP and THP(r=0.4142~0.5712, all P<0.05). Conclusions:Heterogeneity of chemosensitivity to antitumor drugs is present in LNMs and PTs of gastric and colorectal cancers. The chemosensitivity of primary gastrointestinal cancer in the histoculture drugs does not give a good indication of the chemosensitivity of metastatic lesions.