發(fā)布時間：2018-10-10 20:38

【摘要】：目的：比較順鉑（Cisplatin，CDDP）與紫杉醇（Paclitaxel，PTX）不同的給藥方案（單次或分次給藥）對卵巢癌細胞SKOV3種群恢復的影響，并觀察該兩種細胞毒制劑分次給藥對復發(fā)性鉑類耐藥及難治性卵巢癌患者的療效。 方法：1.倒置顯微鏡觀察CDDP和/或PTX單次或分次給藥后對SKOV3細胞凋亡與種群恢復的影響；并用CCK-8法分別測定各處理組在第7天（D7）及D21的吸光度值（Optical density，OD）。2.對20例復發(fā)性鉑類耐藥和難治性卵巢癌患者進行CDDP90mg/m2分為D1, D2, D3+PTX175mg/m2分為D1, D8方案化療，通過分析治療前后患者癥狀、體征、影像學檢查及CA125的變化情況，評估這部分患者對該方案的化療反應性，探討該方案的臨床應用價值。 結果：11.1CDDP單次或分次給藥對SKOV3的凋亡與種群恢復的影響無明顯差異（F=70.421，p=0.970）；1.2單用PTX分次給藥及CDDP聯(lián)合PTX分次給藥均較單次給藥明顯抑制SKOV3細胞的種群恢復（F=1872.275，p=0.000；F=1633.565，p=0.000），且其抑制作用在聯(lián)合用藥組中更明顯（F=2500.464，p=0.000）。22.1觀察20例復發(fā)性鉑類耐藥和難治性卵巢癌患者對CDDP90mg/m2分為D1, D2, D3+PTX175mg/m2分為D1, D8化療方案的反應性，結果提示反應率為75%（15/20）,其中完全緩解率為25%（5/20）；2.2該方案主要的不良反應為骨髓抑制和胃腸道反應，積極對癥處理的后，患者對此方案耐受性良好。 結論：細胞學實驗結果提示CDDP聯(lián)合PTX分次給藥可明顯抑制卵巢癌SKOV3細胞的種群恢復。臨床中，，對于復發(fā)性鉑類耐藥和難治性卵巢癌患者，聯(lián)合該兩種藥物分次給藥獲得較好反應性，但具體機理及對臨床患者生存的改善需要進一步探討和觀察。
[Abstract]:Aim: to compare the effects of different regimen of cisplatin (Cisplatin,CDDP) and paclitaxel (Paclitaxel,PTX) on SKOV3 population recovery in ovarian cancer cells. The efficacy of the two cytotoxic agents in patients with recurrent platinum resistance and refractory ovarian cancer was observed. Method 1: 1. The effects of CDDP and / or PTX on apoptosis and population recovery of SKOV3 cells were observed by inverted microscope, and the absorbance values (Optical density,OD) of D7 and D21 were measured by CCK-8 method. Twenty patients with recurrent platinum-resistant and refractory ovarian cancer were treated with CDDP90mg/m2 as D _ 1, D _ 2, D _ 3 PTX175mg/m2 as D _ 1 and D _ 8 regimen chemotherapy. The changes of symptoms, signs, imaging examination and CA125 before and after treatment were analyzed. To evaluate the chemotherapeutic reactivity of these patients and to explore the clinical value of the regimen. Results: there was no significant difference in the effect of single or partial administration of 11.1CDDP on the apoptosis and population recovery of SKOV3 (FF70.421 P0. 970), 1.2 the single administration of PTX and CDDP combined with PTX significantly inhibited the population recovery of SKOV3 cells (FN 1872. 275 p0. 000). The inhibitory effect was more obvious in the combined treatment group than in the combination group. 22.1 the response of 20 patients with recurrent platinum-resistant and refractory ovarian cancer to CDDP90mg/m2 as D _ 1, D _ 2, D _ 3 PTX175mg/m2 divided into D _ 1 and D _ 8 was observed, and the inhibitory effect was more significant in the combination group (F _ (250) 0.464 (P _ (0.000), 22.1 the response of 20 patients with recurrent platinum resistance and refractory ovarian cancer to D1, D _ 2, D _ 3 PTX175mg/m2 was observed. The results showed that the response rate was 75% (15 / 20), and the complete remission rate was 25% (5 / 20), 2.2 the main adverse reactions of the regimen were bone marrow depression and gastrointestinal reaction. Conclusion: cytological results suggest that CDDP combined with PTX can significantly inhibit the population recovery of ovarian cancer SKOV3 cells. For patients with recurrent platinum resistance and refractory ovarian cancer, the combination of the two drugs can obtain better reactivity, but the specific mechanism and the improvement of the survival of the patients need to be further discussed and observed.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R737.31

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