HDST技术应用于卵巢癌新辅助化疗中的效果分析  

Feasibility of HDST in Neoadjuvant Chemotherapy for Ovarian Cancer

作　　者：饶群仙[1] 韦苑 林少丹[1] 彭永排[1] 林荣春[1] 何远桥[3] 林仲秋[1] 陈青松 RAO Qun-xian;WEI Yuan;LIN Shao-dan;PENG Yong-pai;LIN Rong-chun;HE Yuan-qiao;LIN Zhong-qiu;CHEN Qing-song(Department of Gynaecological Oncology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510310,China;Department of Laboratory Animal Science,Nanchang University//Nanchang Royo Biotech Co,.Ltd,Nanchang 330000,China)

机构地区：[1]中山大学孙逸仙纪念医院妇科肿瘤专科,广东广州510120 [2]广东药科大学公共卫生学院,广东广州510310 [3]南昌大学实验动物科学中心//南昌乐悠生物科技有限公司,江西南昌330000

出　　处：《中山大学学报（医学科学版）》2020年第5期795-801,共7页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：江西省实验动物重点实验室建设项目(20192BCD40003)。

摘　　要：【目的】探讨卵巢癌患者新辅助化疗效果以及在卵巢癌常用化疗方案筛选中应用HDST技术的可行性。【方法】回顾性分析于中山大学孙逸仙纪念医院妇科肿瘤专科收治的11例按照NCCN指南推荐的行新辅助化疗的晚期卵巢癌患者,采集其社会人口学、临床资料及组织标本,并应用HDST技术进行药敏检测。按照HDST药敏结果进行分组,比较组间CA125、HE4与Fagotti评分指标总下降率的差异,探讨HDST结果与患者肿瘤指标下降率的关系。【结果】HDST结果显示6例患者对选用的铂类药(顺铂或卡铂)不敏感,1例患者对紫杉醇不敏感;经3次新辅助化疗后患者肿瘤指标均呈现明显的逐次下降趋势。HDST结果与临床疗效间一致性较好(Kappa=1.000,P<0.05),灵敏度、特异度和正确指数为100%;患者Fagotti评分变化和HDST有效率间存在显著正相关(rs=0.678,P<0.05),而CA125、HE4总下降率和HDST有效率间无相关(P>0.05)。【结论】HDST技术在卵巢癌的新辅助化疗方案筛选上具有快速方便、经济实惠,结果与临床疗效一致的优势,有望为卵巢癌患者提供精准的个体化化疗方案。【Objective】To investigate the efficacy of neoadjuvant chemotherapy for ovarian cancer and explore the feasibility of hydrogel embedded histoculture drug sensitivity test(HDST)use in selecting chemotherapy regiments for ovarian cancer.【Methods】We performed a retrospective analysis of 11 patients with advanced ovarian cancer treated with neoadjuvant chemotherapy as recommended by NCCN guidelines at the department of gynaecological oncology in Sun Yatsen Memorial Hospital.Demographics,clinical data and tissue specimens were collected from patient charts.The patients were grouped according to the HDST results.We compared the differences between groups in the total decline rate of CA125,HE4 and Fagotti scores and analyzed their relationship with HDST results.【Results】HDST results showed that 6 patients were not sensitive to the selected platinum drugs(cisplatin or carboplatin)and 1 patient not sensitive to paclitaxel.After 3 times of neoadjuvant chemotherapy,the patients presented a significantly successive decrease in the levels of tumor markers.HDST results were consistent with the clinical efficacy(Kappa=1.000,P<0.05),with 100%sensitivity,100%specificity and 100%Youden′s index.There was a significant positive correlation between changes in Fagotti′sscores and effective rate of HDST(rs=0.678,P<0.05),while no correlation between the total decline rate of CA125 and HE4 and effective rate of HDST(P>0.05).【Conclusions】HDST is fast,convenient and economical in helping select neoadjuvant chemotherapy for ovarian cancer.Additionally,with its consistency with the clinical efficacy,HDST is ex⁃pected to provide an accurate individualized chemotherapy for patients with ovarian cancer.

关 键 词：药敏检测 HDST 卵巢癌 个体化化疗 

分 类 号：R73[医药卫生—肿瘤]