腫瘤藥物敏感性試驗（3）－－試驗結果及與臨床結果比較

Tumor Chemosensitivity Assay, Ⅲ: Clinical Evaluation of in Vitro Chemosensitivity Assay

過去五年內，我們對107例各種腫瘤患者手術切除標本作了腫瘤細胞的分離培養。其中71例能建立腫瘤細胞培養。在原代培養融合後將腫瘤細胞脫下，用型態學及免疫組化法進行鑑定。本文係用microculture tetrazolium test（MTT試驗）測定腫瘤細胞的體外藥物敏感度，共對70例測定了4種抗腫瘤藥物（5FU, mitomycin, adriamycin and cisplatin）的劑量－效應。體外藥物敏感率在大腸直腸癌為5-Fu, 28.6%; adriamycin, 20.7%; mitomycin, 21.4%; cisplatin, 37.4%; 乳癌為5-Fu, 29.4%; adriamycin, 41.2%; mitomycin, 17.6%; cisplatin, 35.3%。本組有15例作了臨床化學治療，並將其結果與體外藥敏試驗作了比較。結果有3例為真陽性，11例真陰性，1例假陽性。從體外藥敏試驗陽性者預測化療結果準確率為75%，從體外藥敏試驗陰性者預測化療結果準確率為100%。全組藥敏試驗總準確率為93.0%。本文指示體外藥敏試驗可對各種腫瘤的化療有一定參考意義與應用價值。

During the past five years, tumor cells were isolated and cultured from surgical excised specimens from 107 cases with various solid tumors. Tumor cell cultures were established in 71 cases. Tumor cells were detached from the flask after the confluence of primary culture and identified by morphological and immunocytochemical studies. The microculture tetrazolium test (MTT assay) was used to determine the in vitro tumor chemosenstivity. The close-effect of four anticancer drugs (5FU, mitomycin, adriamycin and cisplatin) were determined in 70 cultures. The in vitro chemosenstivity assay sensitive rate in colorectal cancer was: 5-Fu, 28.6%; adriamycin, 20.7%; mitomycin, 21.4% and cisplatin, 37.4%. The sensitive rate in breast cancer was: 5-Fu, 29.4%; adriamycin, 41.2%; mitomycin, l7.6% and cisplatin, 35.3%. Clinical effect of chemotherapy was evaluated in 15 cases and compared with the in vitro chemosenstivity assay. There were 3 true-positive cases, 11 true-negative cases and 1 false-positive case. The predictive accuracy for a positive assay was 75%, and the predictive accuracy for a negative assay was 100%. The overall accuracy of in vitro chemosenstivity assay in our group was 93.0%. The results of the present study indicate that the in vitro chemosenstivity assay might provide useful information for assisting the management of various solid tumors.