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目的:建立胶质瘤细胞体外原代培养模型,利用MTT法进行体外药物敏感实验,为临床化疗方案的设计提供理论指导,实施个体化化疗。方法:32例术后病理证实为胶质瘤(WHOⅢ级)的新鲜标本,制备肿瘤单细胞悬液进行体外原代培养,与7种抗肿瘤药物在临床血浆峰值浓度(PPC)条件下作用72小时,MTT法标记存活的肿瘤细胞,用酶标仪检测光密度值(OD),计算出抑制率(IR),检测不同肿瘤个体对化疗药物的敏感和耐药情况,从而指导临床个体化化疗方案的制定。另选取同期符合上述入选标准的20例间变型星形细胞瘤患者作为对照组,按照VM-26加DDP方案经验化疗,化疗4个疗程结束后,复查影像学,按照WHO肿瘤疗效评价标准评价治疗效果,分为稳定(SD),进展(PD),缓解(PR)。结果:32例临床标本的原代培养及药敏试验,其PPC下的抑制率(IR%)>50%者,DDP有20例;VCR有9例;VM-26有12例;VP-16有17例;Procarbazine有7例;BCNU有6例;Taxol有3例;其敏感性依次为:DDP>VP-16>VM-26>VCR>Procarbazine>BCNU>Taxol。根据体外药物敏感实验结果制定个体化化疗方案治疗29例,肿瘤缓解率为47.2%,对照组为29.4%,2组x2检验统计P<0.05。结论:7种常用的抗肿瘤药物均有耐药的情况,进行化疗药物的敏感测定可以避免耐药药物的使用。根据体外药物敏感实验结果制定个体化化疗方案化疗与对照组相比近期疗效较满意。
OBJECTIVE: To establish a primary culture model of glioma cells in vitro and to use MTT method to conduct in vitro drug-sensitive experiments to provide theoretical guidance for the design of clinical chemotherapy regimens and to implement personalized chemotherapy. Methods: Thirty-two fresh specimens of gliomas (WHO grade Ⅲ) were confirmed by pathology. Primary single cell suspension was prepared for primary culture in vitro and incubated with seven anticancer drugs at peak plasma concentration (PPC). Hour, the surviving tumor cells were labeled with MTT method, the optical density (OD) was detected by microplate reader, the inhibition rate (IR) was calculated, and the sensitivity and drug resistance of chemotherapeutic drugs in different tumor individuals were detected to guide clinical individualized chemotherapy Program development. In addition, 20 patients with astrocytomas who meet the above inclusion criteria were enrolled as the control group. According to the VM-26 plus DDP regimen experience chemotherapy, after 4 courses of chemotherapy, imaging was reviewed and evaluated according to the WHO evaluation criteria of tumor efficacy Effect, divided into stable (SD), progress (PD), alleviation (PR). Results: The primary culture and drug susceptibility tests of 32 clinical specimens showed that the rate of inhibition (IR%) under PPC was> 50%, DDP was 20, VCR was 9, VM-26 was 12, VP-16 There were 7 cases of Procarbazine, 6 cases of BCNU and 3 cases of Taxol. The sensitivity of the study was DDP> VP-16> VM-26> VCR> Procarbazine> BCNU> Taxol. According to the results of in vitro drug-sensitive experiments, 29 cases were treated with individual chemotherapy regimen. The response rate was 47.2% in the control group and 29.4% in the control group. P <0.05 was statistically significant for the two groups. Conclusion: The 7 commonly used antitumor drugs are resistant, and the sensitive determination of chemotherapeutic drugs can avoid the use of drug-resistant drugs. According to in vitro drug-sensitive experimental results to develop individualized chemotherapy regimens compared with the control group, the recent efficacy is more satisfactory.