ATP生物荧光肿瘤体外药敏检测技术在治疗非小细胞肺癌胸水中的临床应用

目的：研究三磷酸腺苷-生物荧光肿瘤体外药敏检测技术(ATP-TCA)在非小细胞肺癌(NSCLC)化疗中的应用,为临床治疗方案的选择提供依据。方法：选择52例伴有胸水的NSCLC患者，根据患者及家属治疗意愿分为经验治疗组和药敏治疗组。经验治疗组20例患者根据经验给予(紫杉醇联合卡铂,PTX+CBP)标准方案全身化疗；药敏治疗组32例患者对胸水标本分别进行顺铂(DDP) 、诺维本(NVB) 、紫杉醇(PTX) 、卡铂(CBP) 、健择(GEM)、PTX+CBP、NVB+CBP、GEM + DDP体外药敏检测，根据体外药敏检测结果选用化疗方案，比较2组患者治疗有效率。结果:体外药敏试验，单一用药中NVB和PTX对 NSCLC的体外敏感率最高，均为28.1 % ；GEM的体外敏感率次之，为25%；CBP的体外敏感率为21.9%；DDP的体外敏感率最低，为17.6%。联合用药方案显示较好的治疗效果,其中GEM + DDP 的体外敏感率最高,达55.9%；PTX+CBP的体外敏感率次之，达50%； NVB+CBP的体外敏感率最低，为40.6%。药敏治疗组患者有效率为65.6%,经验治疗组有效率为40.0%，两组有效率比较差异有统计学意义（P＜0.05）。结论：不同化疗药物对NSCLC的体外敏感率不同；根据药敏试验结果选择化疗方案可取得更
好的临床治疗效果。

Clinical application of ATP - tumor chemosensitivity assay of in vitro susceptibility test in treatment of pleural fluid in patients with non-small cell lung cancer

Objective To study the application of ATP-tumor chemosensitivity assay of in vitro susceptibility test in the chemotherapy of non-small cell lung cancer(NSCLC),and provide basis for selection of clinical therapy program.Methods 52 samples of NSCLC with pleural fluid were selected and divided into two groups.The patients in experience treatment group(n=20) were given the standard program based on experience Paclitaxel(PTX)+ Caboplatin(CBP)];the pleural fluid specimes in susceptibility treatment group(n=32) were given in vitro susceptibility test for cisplatin(DDP),navelbine(NVB),PTX,CBP,gemcitabine(GEM),PTX+CBP,navelbine and NVB+CBP,GEM + DDP,the chemotherapy program was selected according to the results of in vitro susceptibility test;and the efficiency was compared between two groups.Results A single medication,NVB and PTX had the highest efficiency of 28.1% to NSCLC in vitro,the efficiency of GEM was 25%,the efficiciency of CBP was 21.95%,the efficicency(17.6%)of DDP was the lowest.Combined program showed good therapeutic effect,in which GEM + DDP had the highest efficiency of 55.9% in vitro,and PTX + CBP up to 50%.NVB+CBP had the lowest efficiency(40.6%) in vitro.The efficiency(65.6%) in suceptibihity treatment group was higher compared with experience treatment group(40.0%)(P<0.05).Conclusion The efficiencies of different chemotherapy drugs for NSCLC in vitro are different.The chemotherapy program based on susceptibility test can achieve better clinical efficacy than experience chemotherapy program.