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目的探讨体外药敏试验指导下脑胶质细胞瘤化疗临床疗效。方法根据47例行肿瘤次全切除术的脑胶质细胞瘤患者的手术切除肿瘤标本采用三磷酸腺苷生物荧光法(ATP-TCA)进行化疗药物体外药敏试验结果制订化疗方案(A组);与A组资料相似的35例患者按常规化疗作为对照(B组)。结果A组中的45例获得药敏结果,体外药敏的总成功率95.7%。其中的30例接受2个周期术后化疗。体外药敏试验结果与临床治疗效果的总符合率为85.8%,敏感性为79.4%,特异性为92.5%,阳性预测值为90.6%,阴性预测值为76.1%。A组完全缓解(CR)2例,部分缓解(PR)5例,稳定(SD)14例,进展(PD)9例,有效率为(CR+PR)为23.3%,疾病控制率为(CR+PR+SD)为70.0%。B组无CR,PR2例,SD13例,PD20例,有效率为5.7%,疾病控制率为(CR+PR+SD)为42.9%。A组有效率及疾病控制率显著高于B组(P<0.05)。结论ATP-TCA法体外药敏试验对筛选敏感药物进行个体化的化疗和提高临床化疗效果具有重要意义。
Objective To investigate the clinical efficacy of chemotherapy in glioma under the guidance of drug sensitivity test in vitro. Methods According to the results of chemosensitivity test of chemotherapeutic drugs in vitro by chemiluminescence assay of adenosine triphosphate (ATP-TCA) in 47 cases of tumor resected by tumor subtotal gastrectomy (A group) Thirty-five patients with similar data received routine chemotherapy as control (group B). Results A group of 45 cases of drug susceptibility results, the overall success rate of drug sensitivity in vitro 95.7%. 30 of them received 2 cycles of postoperative chemotherapy. In vitro susceptibility test results and clinical treatment of the total coincidence rate was 85.8%, the sensitivity was 79.4%, the specificity was 92.5%, the positive predictive value was 90.6%, the negative predictive value was 76.1%. Group A received complete remission (CR) in 2 cases, partial remission (PR) in 5 cases, stable (SD) in 14 cases and progression (PD) in 9 cases. The response rate was (CR + PR) 23.3% + PR + SD) was 70.0%. There were no CR, PR2, SD13 and PD20 in group B, with an effective rate of 5.7% and a disease control rate of (CR + PR + SD) of 42.9%. The effective rate and disease control rate in group A were significantly higher than those in group B (P <0.05). Conclusions The in vitro susceptibility test of ATP-TCA is of great significance for the screening of sensitive drugs for individual chemotherapy and for improving the effect of clinical chemotherapy.