Differences in chemosensitivity between primary and paired metastatic lung cancer tissues: In vitro analysis based on the collagen gel droplet embedded culture drug test (CD-DST)
Differences in chemosensitivity between primary and paired metastatic lung cancer tissues: In vitro analysis based on the collagen gel droplet embedded culture drug test (CD-DST)
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DOI：
10.3978/j.issn.2072-1439.2011.05.02
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发表时间：
2012-02-01
影响因子：
2.5
通讯作者：
Kobayashi, Hisayuki
中科院分区：
文献类型：
--
作者：
Higashiyama, Masahiko;Okami, Jiro;Kobayashi, Hisayuki
背景：为了阐明非小细胞肺癌（NSCLC）患者原发灶和转移灶对抗癌药物化疗敏感性的差异，我们检测了手术切除的 NSCLC 组织的体外化疗敏感性。方法：共纳入 32 例标本：26 例原发灶伴淋巴结转移标本，3 例原发灶伴肾上腺转移灶标本，3 例原发灶伴肾上腺转移灶标本。原发病变与肺部转移灶的标本。采用胶原凝胶液滴包埋培养药物试验（CD-DST）检测组织对顺铂、吉西他滨、长春瑞滨、多西他赛和5-氟尿嘧啶等抗癌药物的敏感性。结果：原发灶和转移灶对每种抗癌药物的体外敏感性程度不同。配对转移病灶对吉西他滨（P=0.029）、长春瑞滨（P=0.012）和多西他赛（P=0.009）的敏感性显着低于原发病灶。长春瑞滨（P=0.035）或多西他赛（P=0.022）配对转移病灶中诊断为CD-DST敏感的病例发生率显着低于原发病灶（P=0.035）。原发灶与配对非淋巴转移灶对吉西他滨的敏感性差异比原发灶与配对淋巴结转移灶之间的差异更明显。结论：配对转移灶对部分抗癌药物的敏感性显着低于原发灶。当使用术后复发患者的原发肿瘤基于 CD-DST 数据进行化疗时，可以通过仔细考虑这些差异来选择合适的方案。
Background: To elucidate the differences in chemosensitivity to anticancer drugs between primary and metastatic lesions in non-small cell lung cancer (NSCLC) patients, we examined the in vitro chemosensitivities of surgically resected NSCLC tissues.Methods: A total of 32 specimens were enrolled: 26 specimens of primary lesions paired with metastases in the lymph node, 3 specimens of primary lesions paired with metastases in the adrenal gland, and 3 specimens of primary lesions paired with metastases in the lung. The collagen gel droplet embedded culture drug test (CD-DST) was applied to examine the sensitivity of the tissues to anticancer drugs, including cisplatin, gemcitabine, vinorelbine, docetaxel and 5-fluorouracil.Results: The degree of in vitro sensitivity to each anticancer drug varied between the primary and metastatic lesions. The sensitivity of the paired metastatic lesions was significantly lower than that of the primary lesions only for gemcitabine (P=0.029), vinorelbine (P=0.012), and docetaxel (P=0.009). The incidence of cases diagnosed as CD-DST-sensitive among the paired metastatic lesions was significantly lower than that for the primary lesions for vinorelbine (P=0.035) or docetaxel (P=0.022). The difference in the sensitivity to gemcitabine between the primary and paired non-lymphatic metastases was clearer than that between the primary lesion and paired lymph node metastases.Conclusions: The sensitivities of the paired metastatic lesions to some anticancer drugs were significantly lower than those of the primary lesions. When performing chemotherapy based on CD-DST data using primary tumors from patients with postoperative recurrence, an appropriate regimen can be selected by carefully considering these differences.