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目的:探讨生物荧光体外肿瘤药敏检测技术(ATP-TCA)在浅表性膀胱癌肿瘤细胞药敏试验中的应用,探讨该技术在指导膀胱癌个体化治疗上的应用价值。方法:对40例浅表性膀胱癌标本进行肿瘤细胞分离,原代培养,应用ATP-TCA技术检测肿瘤标本对五种常用化疗药物的敏感率和耐药率。试验组术后选用最敏感的化疗药物对患者常规行膀胱灌注化疗,对照组选择丝裂霉素进行术后常规化疗。术后随访2年,评价两组膀胱癌复发情况。结果:40例标本中,吡柔比星(THP)、羟基喜树碱(HCPT)、丝裂霉素(MMC)、表柔比星(EPI)、吉西他滨(GEM)的敏感率分别为75.0%、10.0%、5.0%、37.5%、10.0%,肿瘤细胞对五种化疗药物的敏感率和耐药率差异有统计学意义(P<0.01)。膀胱肿瘤对化疗药物的敏感性存在个体差异。术后随访2年,药敏组膀胱癌复发率为17.5%(7/40),对照组膀胱癌复发率为37.5%(15/40)。两组肿瘤复发率差异有统计学意义(P<0.05)。结论:应用ATP-TCA技术检测出的药敏结果能够反映个体对化疗药物的敏感性,可以作为选择灌注化疗用药的理论基础,指导临床用药进行个体化治疗。同时,应用ATP-TCA技术指导临床膀胱癌术后灌注化疗,可显著降低浅表性膀胱癌患者术后复发率,提高临床疗效。
Objective: To investigate the application of biological fluorescent in vitro tumor drug sensitivity detection technology (ATP-TCA) in drug susceptibility testing of superficial bladder cancer cells and to explore the value of this technology in the individualized treatment of bladder cancer. Methods: Forty cases of superficial bladder cancer specimens were isolated and primary cultured. The sensitivity and resistance rate of tumor samples to five commonly used chemotherapy drugs were detected by ATP-TCA. The patients in the experimental group were treated with the most sensitive chemotherapeutic drugs after conventional chemotherapy and the control group received mitomycin C routinely after chemotherapy. The patients were followed up for 2 years to evaluate the recurrence of bladder cancer in both groups. RESULTS: The sensitivity of THP, MMC, MMC, EPI and GEM in 40 specimens was 75.0% , 10.0%, 5.0%, 37.5% and 10.0% respectively. There was significant difference in the sensitivity rate and drug resistance rate between the five chemotherapeutic drugs and the tumor cells (P <0.01). There are individual differences in the sensitivity of bladder cancer to chemotherapy drugs. After 2 years of follow-up, the recurrence rate of bladder cancer in susceptibility group was 17.5% (7/40). The recurrence rate of bladder cancer in control group was 37.5% (15/40). The difference of tumor recurrence between the two groups was statistically significant (P <0.05). Conclusion: The results of drug susceptibility detected by ATP-TCA can reflect individual sensitivity to chemotherapeutic drugs. It can be used as the theoretical basis for choosing chemotherapeutic agents for chemotherapy and guide clinical medication for individualized treatment. At the same time, the application of ATP-TCA to guide the clinical postoperative chemotherapy of bladder cancer can significantly reduce the recurrence rate of superficial bladder cancer patients and improve the clinical curative effect.