四甲基偶氮唑盐比色法体外药敏试验对乳腺癌细胞药物敏感性的预测价值  

Predictive value of in vitro methyl thiazolyl tetrazolium assay chemosensitivity test of cytotoxic drug activity in breast cancer

作　　者：徐梅玉 沈叶 蒋叶平 单远洲 吴涛 Xu Meiyu;Shen Ye;Jiang Yeping;Shan Yuanzhou;Wu Tao(Department of General Surgery,Shanghai Fengxian District Central Hospital ,Shanghai 201499,China)

机构地区：[1]上海市奉贤区中心医院普外科,201499

出　　处：《中国综合临床》2019年第1期5-10,共6页Clinical Medicine of China

基　　金：上海市奉贤区科委课题(20171006).

摘　　要：目的探讨四甲基偶氮唑盐比色法(methyl thiazolyl tetrazolium assay,MTT)体外药敏试验对乳腺癌细胞药物敏感性的预测价值。方法选取2010年1月至2016年7月在上海市奉贤区中心医院普外科住院行乳腺癌改良根治术或保乳术(术前未行放疗和化疗)的192例患者的新鲜肿瘤组织,术后病理均为浸润性导管癌。采用MTT法测定12种药物及3种化疗方案对192例乳腺癌患者的原代培养癌细胞的抑制水平及敏感率。结果(1)乳腺癌细胞对12种药物敏感性从高到低依次为紫杉醇(taxol,PTX) >表阿霉素(epirubicin,EPI)>顺铂(DDP)>5-氟尿嘧啶(5-fluorouracil,5-FU)>米托蒽醌(mitoxantrone,MIT)>长春新碱(vincristine,VCR)>吡柔比星(pirarubicin,THP)>异环磷酰胺(isophosphamide,IFO)>卡铂(cisplatin,CBP)>环磷酰胺(cyclophosphamide,CTX)>甲氨蝶呤(methotrexate,MTX)>长春瑞滨(vinorelbine,NVB),3组化疗方案的敏感性从高到低依次为多西他赛/多柔比星/环磷酰胺(TAC)>环磷酰胺/表柔比星/氟尿嘧啶(CEF)>环磷酰胺/甲氨蝶呤/氟尿嘧啶(CMF)。PTX、EPI、DDP敏感率即对药物敏感的标本例数占总例数的百分比较高,分别为54%(104/192)、42%(81/192)和37%(71/192)。(2)DDP、CBP及MIT在Ⅲ期乳腺癌中的抑制率要高于Ⅰ、Ⅱ期,差异有统计学意义(F值分别为11.14、4.303、3.182,P均<0.05)。(3)HR(-)乳腺癌的敏感率要高于在HR(+)乳腺癌,PTX、EPI、THP、MIT在HER-2(+)乳腺癌的敏感率要高于在HER-2(-)乳腺癌。结论MTT法作为一种应用广泛的药敏实验方法,对乳腺癌新辅助化疗筛选敏感药物、选择临床化疗方案有一定的参考价值。PTX、EPI、DDP对乳腺癌细胞较其他药物敏感。按体外药敏结果进行化疗,化疗有效率的提高以及因无效而更改化疗方案的比例降低。Objective To investigate the value of methyl thiazolyl tetrazolium assay (MTT) in predicting drug sensitivity of breast cancer cells in vitro.Methods From January 2010 to July 2016, one hundred and ninety-two patients with breast cancer who underwent modified radical mastectomy or breast conserving surgery (no preoperative radiotherapy or chemotherapy) in the Shanghai Fengxian District Central Hospital were selected.MTT method was used to determine the inhibitory level and sensitivity of 12 drugs and 3 chemotherapy regimens to primary cultured cancer cells of 192 patients with breast cancer.Results (1)The sensitivity of breast cancer cells to 12 drugs were in sequence from high to low as follows: Paclitaxel (PTX) > Epirubicin (EPI) > Cisplatin (DDP) > 5-Fluorouracil (5-FU) > Mitoxantrone (MIT) >Vincristine (VCR) > Pirarubicin (THP) > Isosophosphamide (IFO) > Carboplatin (CBP) >Cyclophosphamide (CTX) > Methotrexate (MTX) > Changchun Rui bin (NVB). The sensitivity of chemotherapy regimens in the three groups from high to low was docetaxel/doxorubicin/cyclophosphamide (TAC)>cyclophosphamide/epirubicin/fluorouracil (CEF)>cyclophosphamide/methotrexate/fluorouracil (CMF). The sensitivity rates of PTX, EPI and DDP were 54% (104/192), 42% (81/192) and 37% (71/192) respectively.(2) The average inhibitory rates of DDP, CBP and MIT in stage III breast cancer was higher than those in stage I and II breast cancer, and the differences were statistically significant (F=11.14, 4.303, 3.182, P<0.05). (3) HR-breast cancer is more sensitive than HR+ breast cancer, PTX, EPI, THP, MIT in HER-2(+ ) breast cancer is more sensitive than in HER-2(-)breast cancer.Conclusion As a widely used drug sensitivity test method, MTT assay has a certain reference value for screening sensitive drugs and selecting clinical chemotherapy regimens in neoadjuvant chemotherapy of breast cancer.PTX, EPI and DDP are more sensitive to other breast cancer cells than other drugs.Chemotherapy based on in vitro susceptibility results improves the efficiency of c

关 键 词：MTT试验 乳腺癌 细胞 药物敏感试验 

分 类 号：R737.9[医药卫生—肿瘤]