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目的探讨体外药敏试验指导恶性脑胶质瘤化疗的临床效果及意义。方法对恶性脑肿瘤标本常规采用MTT法进行7种化疗药物体外药敏试验,以指导临床化疗方案的制定。将临床化疗效果与体外药敏结果相比较,分析二者间的符合情况。结果对147例人脑恶性肿瘤手术标本进行体外药敏试验,获得药敏结果的85例,其体外药敏的总成功率58%,早期阶段成功率只有33%,后期到达82%。其中68例为恶性胶质瘤,31例接受化疗。进入疗效评价的共22例,共化疗84个周期,平均3.8个周期。采用一个化疗方案化疗者17例,2个方案化疗者3例,3个方案化疗者2例,总计疗效评价29例次。体外药敏试验结果与临床治疗效果的总符合率为82.8%,阳性符合率为71.4%,阴性符合率为93.3%。体外药敏试验预示的敏感性为90.9%,特异性为77.8%。根据药敏试验结果进行化疗的临床结果:完全缓解(CR)2例,部分缓解(PR)2例,稳定(SD)6例,进展(PD)4例,客观有效率为(CR+PR)为28.6%,疾病控制率为(CR+PR+SD)为71.4%;药敏试验没有发现敏感药物者(凭临床传统用药)组无CR、PR,SD1例,PD14例,客观有效率为0%,疾病控制率为(CR+PR+SD)为6.7%。客观有效率及疾病控制率在药敏试验敏感组显著高于耐药组(P<0.05)。结论MTT体外药敏试验对排除无效药物、筛选敏感药物进行个体化的化疗,提高临床化疗效果,具有重要意义。
Objective To investigate the clinical effect and significance of drug susceptibility testing guided malignant glioma chemotherapy in vitro. Methods The malignant brain tumor specimens were routinely treated with MTT assay in vitro for seven chemotherapeutic drugs to guide the development of clinical chemotherapy regimens. The effect of clinical chemotherapy and in vitro susceptibility results compared to analyze the compliance between the two. Results In vitro antimicrobial susceptibility tests were performed on 147 cases of human malignant tumor. The drug susceptibility results were obtained in 85 cases. The total success rate of drug sensitivity in vitro was 58%. The successful rate was only 33% in early stage and 82% in late stage. Of these, 68 were malignant gliomas and 31 received chemotherapy. To enter the evaluation of a total of 22 cases, a total of 84 cycles of chemotherapy, an average of 3.8 cycles. Seventeen patients were treated with one chemotherapy regimen, three patients were treated with two regimens and two patients were treated with three regimens. The total response rate was 29 cases. In vitro susceptibility test results and clinical effect of the total coincidence rate was 82.8%, the positive coincidence rate was 71.4%, the negative coincidence rate was 93.3%. In vitro susceptibility testing predicts a sensitivity of 90.9% and a specificity of 77.8%. According to the result of drug susceptibility test, the clinical results of chemotherapy were as follows: 2 cases of complete remission (CR), 2 cases of partial remission (PR), 6 cases of stable (SD) and 4 cases of progressive (PD) (CR + PR + SD) was 71.4%. There were no CR, PR, SD and PD in 14 patients with no drug sensitivity test (the traditional clinical drug use), and objective response rate was 0 %, Disease control rate (CR + PR + SD) was 6.7%. Objectively effective and disease control rates in the sensitivity-sensitive group were significantly higher than those in the resistant group (P <0.05). Conclusion MTT in vitro susceptibility testing of exclusion of ineffective drugs, screening of sensitive drugs for individual chemotherapy, improve the efficacy of clinical chemotherapy, is of great significance.