To Study The Correlation To Chemosensitivity Tests Of Peripheral Blood Lymphocytes Of Hepatocellular Carcinoma Patients

Objective: Chemosensitivity test (CST) is considered as a perfect treatment for individual chemotherapy of patients with malignant tumors, and was attempted to treat more and more tumor patients. Multi-drug resistance is one of the major causes of treatment failure of chemotherapy for hepatocellular carcinoma (HCC). Individual chemotherapy under CST becomes more important gradually. So far some problems between CST and HCC chemotherapy are still unclear: e.g. if CST can be done without tumor tissues, instead of the peripheral blood lymphocytes(PBL); can man use the CST results as a guideline for TACE treatment and how will be the effectiveness for HCC patients; whether the sensitivity of HCC will be changed during the treatment course; and if the changes are disciplinary and so on. To answer the problems mentioned above ,this study aims to further explore CST correlations between tumor cells(TC)and PBL in patients with HCC; to investigate the feasibility of using PBL for CST instead of TC for CST; to observe the changes of CST during the clinical course and understand the disciplinary of the changes. Finally to find the scientific basis of reasonable chemotherapy for HCC.Methods: This study was divided into three parts.(1) correlation of sensitivity between TC and PBL in HCC: 37 cases with HCC confirmed by pathology, blood samples were measured in the pre-operation,and the TC were collected during operation, MTT assay was used to test the sensitivity to 10 kinds of anti-cancer drugs of thses cells, the difference of sensitivity were detected by contrastive analysis.(2) Serum AFP and CA125 levels were in 30 HCC patients both before and after treatment of TACE as well as in 30 controls. (3) the changes of sensitivity of 10 chemotherapeutic drugs in different periods: CST were measured before and after chemotherapy at 1,3,6,12 month using PBL, and to guide the chemotherapy,and the difference of multiple result were detected by contrastive analysis. The data were input into computer by a trained worker and analyzed by statistic software SPSS17.0 and Excel 2003.Results: (1) The inhibitory effects were no significant difference(P>0.05 ) and positively correlated between the two(r=0.803 , P=0.005),and sensitive to the chemotherapeutic drugs OXA,DDP,EADM,5-FU,GZ, nonsensitive to VCR,MTX.(2) After TACE treatment, serum AFP and CA125 levels were dropped obviously(P<0.05).(3) 29 case were involved in our study, there were significant statistical sense between before and after chemotherapy at 1, 3,6 month and after chemotherapy at 1, 3,6,12 month correlation coefficient(P<0.05),but notsense to between before and after at 12 month and 6 ,12 month(P>0.05)for 4 times. The chemosensitivity decreases gradually with increasing times in the initial 4 times.Chemosensitivity were certain increases in later result than at 6 month except for OXA and MTX .Conclusions: (1)PBL should used to replace TC to CST with HCC.(2) It has something clinical feasibility of CST as a guideline for TACE treatment with HCC.(3)To do CST was necessary before every pre-chemotherapy,through CST to master the rules of multidrug resistance,which has an important reference value for clinical chemotherapy of HCC.