目的:建立一种快速确定卵巢癌患者对多种常用化疗药物敏感性的检测方法,初步探讨对卵巢癌患者进行个体化化疗的应用价值.方法:从1例卵巢癌患者初次手术切除的标本中分离腹膜转移灶,进行细胞培养,取第2至第4代细胞,分别以紫杉醇(PTX)、多西紫杉醇(DTX)、顺铂(DDP)、卡铂(CBP)和奈达铂(NDP)单药及两种化疗药物联合干预,采用实时无标记细胞分析技术(RTCA)检测细胞增殖情况,同时观察二甲双胍(MTF)配伍后的化疗增敏作用.结果:NDP组标准化细胞指数(NCI)曲线下降快,在给药后24 h、36 h、48 h和60 h时点的NCI值明显低于其他单药组(P＜0.05).NDP+ DTX组在24 h、36h和48 h时点的NCI值明显低于DDP+ PTX组和CBP+ DTX组(P＜0.05).联合使用MTF后,加药后12～72 h,DDP+PTX+ MTF组的NCI值明显低于DDP+ PTX组(P＜0.05);在12 h、48 h、60 h时点,NDP+ DTX+ MTF组NCI值明显低于NDP+ DTX组(P＜0.05).结论:该原代卵巢癌腹膜转移灶细胞对NDP单药和NDP+ DTX组合最敏感,联合使用MTF可增加该细胞对化疗药物的敏感性.RTCA系统可对卵巢癌腹膜转移肿瘤细胞的药物敏感性进行快速分析,为优选合理的临床化疗方案、判断患者是否适用MTF作为增敏剂提供依据.%Objective:To establish a fast method for determining the sensitivity of various common-used chemotherapy drugs in ovarian cancer patients and evaluate its application value of individualized chemotherapy for ovarian cancer.Methods:Primary tumor cells from the peritoneal metastases tissues of a primary surgery ovarian cancer patient were cultured.Low passage (P2-P4) cell susceptibility to common-used chemotherapy drugs such as paclitaxel,docetaxel,cisplatin,carboplatin,nedaplatin alone or their combination were detected.The sensitization effect of metformin was observed.Results:The normalized cell index (NCI) curve of the platinum group decreased rapidly,and the NCI value was significantly lower than that of other single drugs at 24 h,36 h,48 h and 60 h (P＜0.05).The NCI value of the nedaplatin+docetaxel group at 24 h,36 h and 48 h were significantly lower than that of other two groups (P＜0.05).The NCI value of metformin combination groups were significantly lower than those of the non-compatibility groups at 12 h,48 h and 60 h (P＜0.05).Conclusion:This original peritoneal metastasis ovarian cancer cells were most sensitive to nedaplatin and the combination of nedaplatin and docetaxel,and the combination used of metformin could increase the sensitivity to chemotherapeutic drugs.Analyzing the drug sensitivity of the low passage primary peritoneal metastases cells by RTCA system could provide support for reasonable selection of clinical chemotherapies and judge whether patients could get benefits from the combination used of metformin.
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