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目的用药物敏感试验预测胃癌腹水癌细胞对抗癌药物的敏感性,观察其在指导胃癌合并恶性腹水腹腔内化疗的价值。方法选择47例腹水癌细胞阳性胃癌患者,随机分离19例的腹水癌细胞,用三磷酸腺苷(ATP)法分别检测其对卡铂、泰素、5氟尿嘧啶、顺铂、阿霉素、羟基喜树碱、甲氨蝶呤、丝裂霉素、氮烯咪胺的敏感性,各选择最敏感的1种药物对患者进行腹腔内化疗。观察治疗后腹水完全缓解率、腹水癌细胞转阴率,并与28例顺铂单药腹腔内化疗组比较。结果19例腹水癌细胞对抗癌药物敏感的例数分别为卡铂7例、泰素6例、5氟尿嘧啶6例、顺铂6例、阿霉素5例、羟基喜树碱5例、丝裂霉素5例,对甲氨蝶呤和氮烯咪胺均不敏感。治疗后药物敏感试验组腹水完全缓解率为57.9%,高于顺铂组的28.6%(P<0.05);药物敏感试验组腹水中癌细胞转阴率为68.4%,高于顺铂组的32.1%(P<0.05)。结论用药物敏感试验指导胃癌合并恶性腹水腹腔内个体化化疗,可提高恶性腹水的完全缓解率和腹水中癌细胞转阴率,该治疗方法具有临床实用价值。
Objective To predict the sensitivity of gastric cancer ascites carcinoma cells to anticancer drugs with drug sensitivity test and observe its value in guiding the chemotherapy of gastric cancer with malignant ascites. Methods Totally 47 cases of ascites carcinoma cells positive gastric cancer were selected and 19 cases of ascites carcinoma cells were randomly divided into three groups. ATPase method was used to detect the effect of carboplatin, taxol, 5-fluorouracil, cisplatin, doxorubicin, hydroxycamptothecin , Methotrexate, mitomycin, dacarbazine sensitivity, the choice of the most sensitive to a drug in patients with intraperitoneal chemotherapy. To observe the complete remission rate of ascites after treatment, ascites cancer cell negative rate, and with 28 cases of cisplatin alone intraperitoneal chemotherapy group. Results The number of anti-cancer drug in 19 cases of ascites was 7 cases of carboplatin, 6 cases of docetaxel, 6 cases of 5-fluorouracil, 6 cases of cisplatin, 5 cases of doxorubicin, 5 cases of hydroxycamptothecin, 5 cases of mitomycin, methotrexate and dacarbazine are not sensitive. After treatment, the complete remission rate of ascites was 57.9% in the drug sensitive test group, which was higher than that in the cisplatin group (P <0.05). The negative rate of cancer cells in the drug sensitive test group was 68.4%, which was higher than that in the cisplatin group (32.1%, P < 0.05). Conclusion The drug sensitivity test guided gastric cancer with malignant ascites in patients with intraperitoneal chemotherapy can improve the complete remission rate of malignant ascites and cancer cells in ascites, the rate of conversion of this treatment has clinical value.