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目的测定肝细胞性肝癌组织对常用化疗药的敏感性,探讨肝癌组织多药耐药患者的临床病理特征。方法对2010年3月至2011年3月间在中山大学肿瘤防治中心肝胆科行肝癌切除术的100例患者标本进行体外药物敏感性实验,测定目前常用8种化疗药的抑瘤率,包括紫杉醇、开普拓、卡铂、丝裂霉素C、氟脲苷、亚砷酸、表阿霉素和吉西他滨;将患者分为2组:多药耐药组(敏感药物<4种)与非多药耐药组(敏感药物≥4种),分析患者的临床病理特征;分析肝内多病灶数与癌组织耐药数的相关性。结果化疗药物对肝癌组织的抑瘤率从高到低为紫杉醇、开普拓、卡铂、丝裂霉素C、氟脲苷、亚砷酸、表阿霉素和吉西他滨,分别为60%,44%,41%,39%,37%,29%,24%及13%,差异有统计学意义(P<0.05);两组患者的肝内多病灶情况存在显著差异;肝内多病灶数与癌组织耐药数正相关。结论常用化疗药物对肝细胞性肝癌组织的敏感度最高为紫杉醇。肝内多病灶的患者更易发生耐药,而且病灶数目越多耐药数目就越多。
Objective To determine the susceptibility of hepatocellular carcinoma to chemotherapeutic drugs and to investigate the clinicopathological features of multidrug resistance in hepatocellular carcinoma. Methods From March 2010 to March 2011 in Sun Yat-sen University Cancer Center hepatobiliary resection of 100 cases of patients with drug-susceptibility tests to determine the commonly used eight kinds of chemotherapy drugs in tumor inhibition rate, including paclitaxel , Capecitabine, carboplatin, mitomycin C, floxuridine, arsenious acid, epirubicin and gemcitabine. The patients were divided into two groups: multi-drug resistant group (<4 kinds of sensitive drugs) Multi-drug resistance group (sensitive drugs ≥ 4 species), analysis of the clinical and pathological features of patients; analysis of intrahepatic multifocal number and the number of cancer tissue resistance. Results The inhibitory rates of chemotherapy drugs on hepatocellular carcinoma tissue were paclitaxel, capecitabine, carboplatin, mitomycin C, floxuridine, arsenious acid, epirubicin and gemcitabine with the highest rates of 60% 44%, 41%, 39%, 37%, 29%, 24% and 13%, respectively (P <0.05). There were significant differences in intrahepatic multiple lesions between the two groups. Positive correlation with cancer tissue resistance. Conclusion The highest sensitivity of chemotherapeutic drugs to hepatocellular carcinoma is paclitaxel. Patients with multiple intrahepatic lesions are more likely to develop resistance and the more the number of lesions, the more resistant.