Study Of Drug Resistance In Lung Cancer And Treatment Of Malignant Pleural Effusion

Part I Expression and significance of apoptosis-related genes in parental and drug-resistant lung adenocarcinoma cell lineObjective To study the expression of drug resistance and apoptosis-related genes in A549DDP and the parental A549 cell line Method Expression of apoptosis- related genes was examined by Oligo GE Array Assay. Result The expression of BAD,BAG3,BFAR,CARD8,CASP6,GADD45,TNFRSF14,CD70,TRADD,TRAF1 and TRAF3genes were increased in A549DDP cells compared to A549 cells, but the expression of BAG1,BAX,BCL2L2,XIAP,BIRC8,BNIP2,CARD14,NOD2,NOD1,CARD6,CASP1,CASP4,CASP9,CIDEB,CRADD,DFFB,HRK,TNFRSF1B,TP53BP2 and TRAF5 genes were decreased in A549DDP cells compared to A549 cells. Conclusion This result suggests that the altered genes may play roles in anti-apoptosis and drug resistance in A549DDP cellsPart II Clinical Study of Malignant Pleural EffusionObjective To summarize the clinical diagnosis and treatment of malignant pleural effusion in our hospital. Method To analyze retrospectively clinical data of 114 cases of lung cancer complicated with malignant pleural effusion in our hospital from 2006 to 2008, and evaluate the diagnosis and treatment. Result Pleural effusions from all patients were collected for detection of hydrothorax exfoliated cells. 110 cases have been confirmed, including 38 cases of pleural effusion that is the first inspection to find cancer cells, and the rest has been diagnosed through several times examination; 4 cases of pleural effusion has been confirmed through check-assisted thoracoscopic pleural biopsy.After exclusion of pleural effusion, pleural adhesion agent were injected into into the pleural space in 76 patients. 46 cases were injected with Highly Agglutinative Staphylococcin, total effectively rate for this group was 85.37%. Adverse event consisted of fever, which had been happened in 15 cases accounting for 32.6%), and chest pain, which had been happened in 10 cases accounting for 21.74%. 15 cases were injected with Corynebacterium parvum, total effective rate for it was 61.54%. Adverse reactions were fever, which was seen in 8 cases (53.33%), chest pain in 10 cases (66.67%), abnormal liver and kidney functions in 2 cases (13.33% ); 10 cases were injected with cisplatin, total effective rate was 50%, of which two cases had high fever (20%), eight cases had gastrointestinal reactions (80%), five cases had neutropenia (50%); In addition, 5 cases were injected with talc, during this group, total effective rate was 100%, all of the cases had high fever, severe chest pain. Conclusion According to the above clinical data and literature review, we conclude that the pleural fluid cytology is simple, many submitted to improve the diagnosis rate of pleural effusion. The case who can not be confirmed by Pleural fluid cytology could consider the application of video-assisted thoracoscopic surgery to diagnose. The closed drainage of pleural cavity with central venous catheter is easy to manipulate, with minor trauma, less post-operative complications, convenience in patients with activity and more durable. It is conducive to collecting specimens and repeated administration of pleural cavity, and can increase efficacy, shorten the course, should be used extensively in clinic. Highly Agglutinative Staphylococcin has better efficacy and less side effects in malignant pleural effusion, and can be used as an ideal treatment drug of malignant pleural effusion.