氟尿嘧啶和奥沙利铂在胃癌中的体外化疗敏感性检测  

In Vitro Chemosensitivity of Fluorouracil and Oxaliplatin in Gastric Cancer

作　　者：陈小东[1] 赵平[1] 丁志[1] 周祥[1] 肖硕萌[1] 唐令超[1] 

机构地区：[1]四川省肿瘤医院.研究所胃肠外科,成都610041

出　　处：《肿瘤预防与治疗》2014年第4期165-170,共6页Journal of Cancer Control And Treatment

基　　金：四川省科技计划项目(No.2014FZ0089)

摘　　要：目的:探讨氟尿嘧啶(5-FU)和奥沙利铂(OX)在胃癌中的体外化疗敏感性。方法:纳入病理确诊并自愿接受检测的胃癌患者,采用ATP肿瘤化疗敏感性检测法(ATP-TCA)检测新鲜手术标本对5-FU和OX的体外化疗敏感性。结果:纳入27例,男性21例、女性6例,中位年龄60.0岁,远侧部胃癌14例(51.9%),低分化及印戒细胞癌共20例(74.1%),TNMⅢ+Ⅳ期21例(77.8%)。ATP-TCA检测显示5-FU+OX在各药物浓度的肿瘤生长抑制率均显著高于5-FU或OX(P<0.05),5-FU+OX的抑制曲线下面积显著高于5-FU或OX(P<0.05);而其化疗敏感指数、IC90和IC50显著低于5-FU或OX(P<0.05)。5-FU、OX和5-FU+OX的体外化疗敏感性依次为18.5%、14.8%和55.6%,5-FU+OX的敏感性显著高于5-FU或OX(5-FU+OX vs.5-FU:P=0.001和5-FU+OX vs.OX:P=0.003)。Logistic回归分析显示5-FU的敏感性与临床病理特征无显著相关性,而OX和5-FU+OX的敏感性分别与Borrmann分型(OR=7.570,P=0.025)和肿瘤位置(OR=3.427,P=0.019)有显著相关性。结论:5-FU+OX在胃癌中显示出较高的体外化疗敏感性,但其与体内疗效的相关性有待进一步临床观察。Objective： To investigate the in vitro chemosensitivity of fluorouracil （5-FU） and oxaliplatin （OX） in gastric cancer. Methods：Patients with histologically confirmed gastric cancer were enrolled for the study. All patients a-greed to the chemosensitivity test of their resected tumors and gave informed consent. Adenosine triphosphate tumor chemo-sensitivity assay （ ATP-TCA） was performed to determine the chemosensitivity of 5-FU and OX in resected gastric cancer specimens. Results：Twenty-seven patients with a median age of 60. 0 were enrolled, including 21 males and 6 females. The tumors were located in the lower part of the stomach in 14 cases, 20 cases were poorly differentiated or signet-ring cell carcinoma and 21 cases were in late TNM stage. ATP-TCA assay showed that the tumor growth inhibition rates of 5-FU＋OX were significantly higher than those of 5-FU or OX at each test drug concentration （ P〈0. 05 ）; correspondingly, the area under the curve of 5-FU＋OX was significantly higher than those of 5-FU or OX （P〈0. 05）, whereas their chemosen-sitivity index, IC90 and IC50 were significantly lower than those of 5-FU or OX （P〈0. 05）. The chemosensitivity rates of 5-FU, OX and 5-FU＋OX were 18. 5%, 14. 8% and 55. 6%, respectively; chemosensitivity of 5-FU＋OX was signifi-cantly higher than that of 5-FU or OX （5-FU＋OX vs. 5-FU：P=0. 001 and 5-FU＋OX vs. OX：P=0. 003）. Logistic re-gression analysis indicated that the chemosensitivity of 5-FU was not significantly correlated with any clinicopathological characteristics;however, the chemosensitivity of OX and 5-FU＋OX was significantly correlated with Borrmann type （ OR=7. 570, P=0. 025） and tumor location （OR=3. 427, P=0. 019）, respectively. Conclusion：5-FU＋OX showed high in vitro chemosensitivity in gastric cancer, and may be worthy of further exploration to see its correlation with in vivo efficacy.

关 键 词：胃癌 三磷酸腺苷 化疗敏感性 氟尿嘧啶 奥沙利铂 

分 类 号：R735.2[医药卫生—肿瘤] R730.53[医药卫生—临床医学]