Study Of The Correlation Of Drug Sensitivity Among Primary Lesion,Metastasis And PBL Of Advanced Gastric Cancer In Vitro

Objective:The death rate of gastric cancer is the highest among all of the malignant tumors in our country. The absorbent gland matastasis is important in the prognosis, for the recur after the radical correction. The chemotherapy, the most efficient method after the operation,plays an important role in preventing and curing both palindromia and metastasis. However the chemotherapy is approving on and on, it is unable to choose chemotherapy individualized yet, partly because of the different sensitivity among drugs and patients. Undoubtedly this is one of the most important reasons to lead to chemotherapy fail,therefore individualized chemotherapy become the hot spot of chemotherapy study. At present, the researches on the sensitivity of chemodrug in vitroare limited to the primary lesion, and malignant abdominal dropsy and malignant pleural fluid. In this condition, some patients, who ether have lost the chance of operation, or have durg resisitant after operation ,or want to receive the neoadjuvant chemotherapy, don't have the opportunity to have this examination, because of the simple resource of the biopsy. So we also couldn't detect these patients' drug sensitivity. It make that these patients'therapeutic effect couldn't be improved. So it has actuality significance to find a kind of specimen to take place of the primary lesion with the drug sensitivity test. At present the study of drug sensitivity of metastasis is still not be reported. And the chemotherapy shoud be more scientific if it is aimed at metastasis instead of primary lesion,especially after operation. We investigated the correlation of drug sensitivity among tumor cells,metastatic lymph-node cells and peripheral blood lymphocyte (PBL) in vitro. To study the sensitivity of chemotherapeutic agents by use of peripheral blood lymphocyte instead of cancer cells of patients to instruct the individual therapyMethods:36 tumor tissues and metastatic lymph node (confirmed by patho)resected by surgical operation from the patients with gastric cancer were treated by mechanical dispersion method for single cell suspension respectively,and 36 peripheral blood specimens were treated by lymphocyte separating medium. The OD values were detected by MTT method and the CI values to 6 kinds of chemotherapy scheme, 5-FU,CDDP,L-OHP,CPT-11,5-FU+CDDP and 5-FU+L-OHP, were calculated according to the formula.Results:1 The chemotherapeutics sensitivity of different patient with gastric cancer has conspicuous individual difference. In tumor cell, the ranges of average inhibiting rates about different chemotherapy scheme were (20.7~29.1); in metastatic lymph node were (22.7~57); in PBL were (21.8~30.1).2 The average inhibiting rates of 5-FU,CDDP,L-OHP,CPT-11,5-FU+CDDP and 5-FU+L-OHP to tumor cell were arranged in order were 5-FU+CDDP>5-FU+L-OHP> CDDP>L-OHP>CPT-11>5-Fu; in metastatic lymph node were 5-FU+L-OHP>5-FU+CDDP>L-OHP>CPT-11>5-Fu> CDDP; in PBL were 5-FU+L-OHP > 5-FU+CDDP> L-OHP> CDDP > CPT-11> 5-Fu.3 For the 5 chemotherapy schema such as 5-FU,L-OHP,CPT-11,5-FU+CDDP and 5-FU+L-OHP ,the drug sensitivity discrepancy between metastatic lymph-node cells and tumor cells is not conspicuous (P>0.05). Only for the CDDP, the drug sensitivity discrepancy is conspicuous (P<0.05). Inversely, the drug sensitivity discrepancy between PBL and tumor cells or metastatic lymph-node cells is conspicuous (P>0.05) for subtotal chemotherapy schema. Moreover for all of chemotherapy schema, the drug sensitivity of PBL were lower than he drug sensitivity of tumor cells or metastatic lymph-node cells.4 There is a significant positive correlation in the drug sensitivities between metastatic lymph-node cells and tumor cells to the most of the chemotherapy schema such as 5-FU,CDDP,L-OHP,CPT-11 and 5-FU+L-OHP(P<0.05). And there is a significant positive correlation in the drug sensitivities between metastatic lymph-node cells and PBL as well as between tumor cells and PBL to the parts of chemotherapy schema(P>0.05).Conclusion:1 The tumor cells,metastatic lymph-node cells and PBL with gastric cancer in different individuals have different sensitivity to the same chemotherapy schema, have conspicuous individual variation.2 For the same chemotherapy schema, the drug sensitivity discrepancy between metastatic lymph-node cells and tumor cells is not conspicuous. And the drug sensitivity discrepancy between PBL and tumor cells or metastatic lymph-node cells is conspicuous for the same chemotherapy schema. The drug sensitivity of PBL were lower than he drug sensitivity of tumor cells or metastatic lymph-node cells.3 There is a significant positive correlation in the drug sensitivities between metastatic lymph-node cells and tumor cells. And there is a significant positive correlation in the drug sensitivities between metastatic lymph-node cells and PBL as well as between tumor cells and PBL.4 It is still unable to enforce individualized chemotherapy based on drug sensitivity effect of PBL instead of primary lesion and metastasis . But we can choose the chemotherapy schema base on the drug sensitivity of tumor cells and PBL. In order to lessen the inhibitory of anticancer drugs to the PBL in the chemotherapy.5 Metastatic lymph-node may take place of tumor tissue to select the sensitive drugs when tumoe tissue specimen couldn't be gotten for the patients with advanced gastric cancer who have lost the chance of radical surgery. In order to efficaciously prevent the recidivation and aversion after the operation.6 For the patients who may have micrometastasis ,but we couldn't get the metabasis , we can choose the sensitive drugs base on the sensitivity of primarily tumor tissue.7 For the patients with advanced gastric cancer, we can try to choose the sensitive drugs base on the sensitivity of metastatic lymph-node which have be confirm by the biopsy of far metastatic lymph-node.