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目的:研究消化道肿瘤体外化疗药敏性与其临床病理因素的关系。方法:对35例胃癌、37例大肠癌进行MTT法肿瘤细胞原代培养药物敏感性实验,同时检测了癌组织P-gp、GSTπ-和p53蛋白的表达。结果:9种化疗药物对肿瘤细胞抑制率在性别、肿瘤直径间差异变化均不明显,P均>0.05;5-氟尿嘧啶(5-FU)、奥沙利铂(L-OHP)、表柔比星(EADM)、吡柔比星(THP)和丝裂霉素(MMC)对<65岁者的肿瘤抑制率高于≥65岁者(P均<0.05);5-FU、Vp-16、L-OHP、EADM和THP对胃癌的抑制率高于大肠癌,P<0.05;5-FU、Vp-16、PTX、L-OHP和DDP对低分化腺癌的抑制率高于高中分化癌(P<0.05);仅HCPT、L-OHP的抑制率在Ⅲ~Ⅳ期明显高于Ⅰ~Ⅱ期,P值为0.047和0.007;高中分化腺癌组织中P-gp和GST-π表达明显高于低未分化癌(u=0.002 1、u=0.007 5,P<0.01)。结论:胃肠道癌耐药性与患者的年龄、组织学分级有关,消化道肿瘤临床病理部分特征也具有一定预测肿瘤化疗敏感性的价值。
Objective: To study the relationship between chemosensitivity and clinicopathological factors in vitro of gastrointestinal cancer. Methods: Thirty-five cases of gastric cancer and 37 cases of colorectal cancer were studied by MTT assay. The sensitivity of MTT assay was evaluated by MTT assay. The expressions of P-gp, GSTπ- and p53 were also detected. Results: The inhibitory rates of 9 chemotherapeutic drugs on tumor cells were not significantly different between sex and tumor diameter (P> 0.05). The inhibitory rates of 5-fluorouracil (5-FU), oxaliplatin (L-OHP) The tumor inhibition rates of EADM, THP and MMC in patients <65 years old were higher than those of ≥65 years old (all P <0.05). The inhibitory rates of 5-FU, Vp-16, The inhibitory rates of L-OHP, EADM and THP on gastric cancer were higher than those of colorectal cancer (P <0.05). The inhibitory rates of 5-FU, Vp-16, PTX, L-OHP and DDP on poorly differentiated adenocarcinoma were higher than those in high differentiated cancer P <0.05). The inhibitory rates of HCPT and L-OHP in stage Ⅲ-Ⅳ were significantly higher than those in stage Ⅰ-Ⅱ, P values were 0.047 and 0.007 respectively. The expression of P-gp and GST-π in high differentiated adenocarcinoma was significantly higher In low undifferentiated carcinoma (u = 0.002 1, u = 0.007 5, P <0.01). Conclusion: The drug resistance of gastrointestinal cancer is related to the age and histological grade of the patients. The clinical and pathological features of the gastrointestinal cancer also have the value of predicting the chemosensitivity of the tumor.