【摘要】 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。更多还原

【Abstract】 OBJECTIVE:To explore the relationship between chemosensitivities and clinicopathological features in gastrointestinal tract carcinomas.METHODS:Of the 35 gastric and 37 colorectal cancer patients,the chemotherapy sensitivities in fresh tumor tissues were determined by MTT assay.Simultaneously,the expressions of p53,P-gp and GST-π in cancer specimens were detected by immunohistochemistry.RESULTS:There were no significant differences between the chemosensitivities and gender,tumour size,respectively P<0.05.The inhibition rates of 5-FU,L-OHP,EADM,THP and MMC were significantly lower in elderly patients over 65 years than in others,P>0.05.The inhibition rates of 5-FU,Vp-16,L-OHP,EADM and THP were significantly higher for gastric cancer than for colorectal cancer(P<0.05),and as well as 5-FU,Vp-16,PTX,L-OHP,CDDP for the poorly differentiated carcinomas than for the well-moderately differentiated adenocarcinomas,P<0.05.The inhibition rates of HCPT and L-OHP were significantly higher in stage Ⅲ and Ⅳ than those in stage Ⅰ and Ⅱ,P were 0.047 and 0.007.The expressions of P-gp and GST-π in well-moderately differentiated adenocarcinomas were significantly higher than those in poorly differentiated cancer(u=0.002 1,0.007 5,both P<0.01).CONCLUSIONS:The relative drug-resistance of gastrointestinal carcinomas may be correlated with the elderly patients and the well-moderately differentiated adenocarcinomas.Clinicopathologic part features also may predict the chemotherapeutic response for gastrointestinal tract cancers.更多还原