原发性肝癌体外化学药物敏感性试验及结果分析

目的 测定肝细胞性肝癌组织对常用化疗药的敏感性,探讨肝癌组织多药耐药患者的临床病理特征.方法 对2010年3月至2011年3月间在中山大学肿瘤防治中心肝胆科行肝癌切除术的100例患者标本进行体外药物敏感性实验,测定目前常用8种化疗药的抑瘤率,包括紫杉醇、开普拓、卡铂、丝裂霉素C、氟脲苷、亚砷酸、表阿霉素和吉西他滨;将患者分为2组:多药耐药组(敏感药物＜4种)与非多药耐药组(敏感药物≥4种),分析患者的临床病理特征;分析肝内多病灶数与癌组织耐药数的相关性.结果 化疗药物对肝癌组织的抑瘤率从高到低为紫杉醇、开普拓、卡铂、丝裂霉素C、氟脲苷、亚砷酸、表阿霉素和吉西他滨,分别为60%,44%,41%,39%,37%,29%,24%及13%,差异有统计学意义(P<0.05);两组患者的肝内多病灶情况存在显著差异;肝内多病灶数与癌组织耐药数正相关.结论 常用化疗药物对肝细胞性肝癌组织的敏感度最高为紫杉醇.肝内多病灶的患者更易发生耐药,而且病灶数目越多耐药数目就越多.

Chemical drugs sensitivity tests on primary carcinoma of the liver in vitro and their results analysises

Objective To determine the commonly used chemotherapeutic drugs’ sensitivity on hepatocellular carcinoma.To investigate the clinicopahological features in patients with multidrug resistance.Methods The essays of 100 patients who underwent resection of hepatocellular carcinoma during Mar.2010 to Mar.2011 in Cancer Center of Sun Yat-sen University were detected the sensitivity to taxol,irinotecan,carboplatin,mitomycin C,FUDR,arsenious acid,epirubicin and gemcitabine.The patients were divided into two groups:multidrug resistance group(were sensitive to<4 drugs) and non-multidrug resistance group(were sensitive to≥4 drugs).We then analyzed the relationship between the sensitivity and the patient’s clinicopathological feature,and the correlation between intrahepatic multifocal number and chemotherapeutics resistance of cancer tissue.Results Among the 8 drugs,taxol had the highest tumor inhibition rate.And it was followed by irinotecan,carboplatin,mitomycin C,arsenious acid,FUDR,epirubicin and gemcitabine.The inhibition ratio were 60%,44%,41%,39%,37%,29%,24% and 13% respectively.There were remarkable statistically significant differences.Intrahepatic multi-lesion was different between these two groups.And there was a positive correlation between intrahepatic multifocal number and chemotherapeutics resistance of cancer tissue.Conclusion Among the common chemotherapeutic drugs,taxol has the highest tumor inhibition rate.Patient with intrahepatic multi-lesion is prone to chemotherapeutics resistance.And more the lesions exist,more the resistance drugs are to be.