药敏试验指导下肝癌及肝癌腹腔积液治疗的疗效观察
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[摘要] 目的：观察药敏试验指导下的肝癌及肝癌腹腔积液化学治疗的治疗效果。方法：将性别、年龄与肿瘤类型、分期、腹腔积液量相同的肝癌患者配对，并将配对病例随机分入实验组与对照组。采用MTT法体外检测腹腔积液肿瘤细胞的药物敏感性，实验组选用含肿瘤抑制率较高药物的联合化疗方案，对照组采用联合应用5-氟尿嘧啶、顺铂、表阿霉素方案，对两组患者进行全身化疗和腹腔内化疗。结果：24对配对患者的研究结果显示，实验组腹腔积液治疗有效率为87.50%，对照组腹腔积液治疗有效率为70.83%，两组腹腔积液治疗有效率无显著性差异(P>0.05)；实验组肿瘤治疗有效率为58.33%，对照组肿瘤治疗有效率为33.33%，实验组肿瘤治疗有效率高于对照组(P<0.05)。结论：药物敏感性试验指导下的肝癌化疗其肿瘤治疗的有效率高于常规方法用药。
[关键词] 药敏试验；肝癌；癌性腹腔积液
[中图分类号] R735.7[文献标识码]A [文章编号]1673-7210(2009)02(a)-033-03
Observation on the effect of the treatment with the chemotherapy selected by drug sensitivity assay in liver cancer and m alignant ascites
YUAN Xiao-lin1, LI Zhi-min2, JIN Shi-yu1, ZHANG Chun-lei1, ZHANG Xiu-lin3, YANG Zhen1
(1.The Affiliated Zhongshan Hospital of Dalian University, Dalian116001, China; 2.Dalian Central Hospital, Dalian116023, China; 3. Dalian No.3 Hospital, Dalian116011, China)
[Abstract] Objective: To observe the effect of the treatment with the chemotherapy selected by drug sensitivity assay in liver cancer and m alignant ascites. Methods: The criteria of a matched-pair included patients'age,sex,stage of cancer and the amount of ascites. Patients of a matched-pair were selected into experimental group and control group randomly. Drug sensitivity was tested with MTT method. Patients of experimental group were treated with the chemotherapy selected by drug sensitivity assay,and the patients of control group were treated with combination therapy of 5-FU,DDP and Epirubicin. Results: Among the 24 matched-pair patients,the ascites response rates of experimental group and control group were 87.50% and 70.83% respectively,it showed no statistical difference between the two groups(P>0.05). Meanwhile the tumor response rate of experimental group was 58.33%,which was significantly higher than 33.33% of control group(P<0.05). Conclusion: The response rate of chemotherapy selected by drug sensitivity assay is higher than that of combination therapy of 5-FU,DDP and Epirubicin in liver cancer treatment.
[Key words] Drug sensitivity assay; Liver cancer; M alignant ascites
腹腔积液是晚期肝癌的并发症，目前普遍认为脱落的癌细胞在腹腔内的增殖或腹膜上的种植所形成的癌性腹膜炎是腹腔积液产生的主要原因，杀伤肿瘤细胞或抑制肿瘤细胞的增殖是肝癌腹腔积液治疗的重要内容之一。临床多采用腹腔闭式引流与腔内化疗或腔内肿瘤细胞杀伤药物输注联合应用等手段杀伤腹腔内的肿瘤细胞。腔内化疗的全身毒副作用较弱，但时常因肿瘤细胞对所使用的化疗药物敏感性较低，而使治疗效果受到很大影响。采用腹腔积液中分离到的肿瘤细胞进行药物敏感性试验 ......
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