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目的：探讨卵巢恶性肿瘤体外药物敏感试验的临床意义。方法：采用四氮唑蓝显色反应药敏分析法（ MTT）检测 60例卵巢恶性肿瘤组织（Ⅰ 期 8例、Ⅱ 期 2例、Ⅲ期 22例、Ⅳ期 1例、复发 27例）对化疗药物的敏感性。结果：体外试验单药对肿瘤的中位抑制率为：泰素 61.5％、表阿霉素 52.4％、卡铂 42.1％、平阳霉素 33.5％、长春新碱 10.7％。联合用药的中位抑制率为： VBP(长春新碱＋平阳霉素＋卡铂 )79.9％、 VAP(长春新碱＋表阿霉素＋卡铂 )75.3％。 VBP、 VAP方案对上皮性卵巢癌的中位抑制率分别为 77.3％和 71.0％。初治术后残留灶≤ 2 cm者中 26例可评价，体外试验与临床疗效的符合率为 84.6％。复发术后残留灶≤ 2 cm者中 15例可评价， 10例使用体外敏感药物进行化疗，术后 1年生存率 80.0％， 5例患者体外试验不敏感，术后随意用药， 1年生存率 37.5％（ P >0.05）。术后残留灶 >2 cm者， 7例使用体外敏感药物，仅 1例部分缓解。根据药敏结果， 9例上皮性卵巢癌使用 VBP方案化疗， 3年生存率 66.7％， 5例使用 VAP方案者 3年生存率 53.3％。结论：体外药物敏感试验对指导临床化疗有一定作用， VBP和 VAP方案对上皮性卵巢癌有潜在疗效，值得进一步探讨。
Objective: To investigate the clinical significance of drug sensitivity test in ovarian cancer in vitro. Methods: Sixty cases of ovarian malignant tumors (8 cases in stage Ⅰ, 2 cases in stage Ⅱ, 22 cases in stage Ⅲ, 1 case in stage Ⅳ and 27 cases recurred) were detected by MTT assay. Chemotherapy sensitivity. Results: The median tumor inhibition rate of monotherapy in vitro was 61.5% of taxol, 52.4% of epirubicin, 42.1% of carboplatin, 33.5% of pingyangmycin and 10.7% of vincristine. Median inhibition rate of combination therapy was 79.9% of VBP (vincristine + bleomycin + carboplatin) and 75.3% of VAP (vincristine + epirubicin + carboplatin). The median inhibitory rates of VBP and VAP on epithelial ovarian cancer were 77.3% and 71.0%, respectively. Twenty-six patients with residual tumor less than 2 cm after initial surgery were evaluated, and the coincidence rate of in vitro test and clinical efficacy was 84.6%. Fifteen patients with residual tumor less than 2 cm after reoperation were eligible for evaluation. Ten patients were treated with chemotherapeutic drugs in vitro. The 1-year survival rate was 80.0%. Five patients were insensitive to in vitro test. 37.5% (P> 0.05). Postoperative residual lesions> 2 cm, 7 cases of sensitive drugs in vitro, only 1 case of partial remission. According to the susceptibility results, 9 cases of epithelial ovarian cancer using VBP chemotherapy, 3-year survival rate of 66.7%, 5 cases of VAP program, 3-year survival rate of 53.3%. CONCLUSION: In vitro drug sensitivity test may play a role in directing clinical chemotherapy. The potential therapeutic effect of VBP and VAP on epithelial ovarian cancer is worth further study.