【摘要】 目的：探讨卵巢恶性肿瘤体外药物敏感试验的临床意义。方法：采用四氮唑蓝显色反应药敏分析法（ MTT）检测 60例卵巢恶性肿瘤组织（Ⅰ 期 8例、Ⅱ 期 2例、Ⅲ期 22例、Ⅳ期 1例、复发 27例）对化疗药物的敏感性。结果：体外试验单药对肿瘤的中位抑制率为：泰素 61.5％、表阿霉素 52.4％、卡铂 42.1％、平阳霉素 33.5％、长春新碱 10.7％。联合用药的中位抑制率为： VBP(长春新碱＋平阳霉素＋卡铂 )79.9％、 VAP(长春新碱＋表阿霉素＋卡铂 )75.3％。 VBP、 VAP方案对上皮性卵巢癌的中位抑制率分别为 77.3％和 71.0％。初治术后残留灶≤ 2 cm者中 26例可评价，体外试验与临床疗效的符合率为 84.6％。复发术后残留灶≤ 2 cm者中 15例可评价， 10例使用体外敏感药物进行化疗，术后 1年生存率 80.0％， 5例患者体外试验不敏感，术后随意用药， 1年生存率 37.5％（ P >0.05）。术后残留灶 >2 cm者， 7例使用体外敏感药物，仅 1例部分缓解。根据药敏结果， 9例上皮性卵巢癌使用 VBP方案化疗， 3年生存率 66.7％， 5例使用 VAP方案者 3年生存率 53.3％。结论：体外药物敏感试验对指导临床化疗有一定作用， VBP和 VAP方案对上皮性卵巢癌有潜在疗效，值得进一步探讨。更多还原

【Abstract】 Objective: The current study was designed to investigate the clinical significance of in vitro chemosensitivity test for ovarian cancer. Method: Diphenyltetrazolium bromide(MTT) assay was used to detect chemosensitivity in vitro for 60 cases of ovarian cancer patients (Stage I, 8 cases;StageⅡ , 2 cases; StageⅢ， 22 cases; StageⅣ , 1 case; recurrence 27). Results: The median in vitro inhibition rates (IRs) of single agent to tumor cells were: Taxol 61.5％ , EADM 52.4％ , Carbo 42.1％ , BLM 33.5％ ,and VCR 10.7％ . The median IRs of combined regimen were: VBP (VCR＋ BLM＋ carboplatin) 79.9％ , VAP (VCR＋ epirubicin＋ carboplatin)75.3％ . The median IRs of VBP and VAP to specific histology of epithelial ovarian cancer(EOC) were 77.3％ and 71.0％ , respectively. The chemosensitivity test correctly indicated chemotherapy efficacy in 84.6％ of 26 primary evaluable cases with residue tumor of≤ 2 cm. In 15 evaluable of recurrent cases with residue tumor of≤ 2 cm , the 1 year survival rate was 80.0％ of 10 in vitro drug sensitive cases and 37.5％ of 5 in vitro drug resistsnt ones (P >0.05). In 7 cases with residue tumor of >2 cm, only one reached partial response even though they received chemotherapy as indicated by chemosensitivity test. The 3 year survival rate of 9 patients who had received VBP chemotherapy suggested by chemosensitivity was 66.7％ , and of 5 patients received VAP treatment,it was 53.3％ . Conclusion: Chemosensitivity is helpful for guiding chemotherapy in ovarian cancer patients. VAP and VBP regimen showed promising effect on epithelial ovarian cancer and deserved to be further studied.更多还原