吉林大学学报(医学版) ›› 2021, Vol. 47 ›› Issue (3): 731-739.doi: 10.13481/j.1671-587X.20210325

• 临床研究 • 上一篇    下一篇

基于miniPDX动物模型筛选化疗方案治疗卵巢癌的临床效果评价

苏丹,刘屹,崔慢慢,杨年,黄宇,何文静()   

  1. 四川省人民医院妇产科 四川省医学科学院,四川 成都 610072
  • 收稿日期:2020-09-05 出版日期:2021-05-28 发布日期:2021-05-28
  • 通讯作者: 何文静 E-mail:104982648@qq.com
  • 作者简介:苏 丹(1980-),女,四川省成都市人,主治医师,医学博士,主要从事妇科肿瘤方面的研究。
  • 基金资助:
    四川省卫计委普及应用项目(17PJ240);四川省成都市科技局重点研发支撑计划项目(2019-YF05-00244-SN)

Evaluation of clinical effect of screening chemotherapy regimens in treatment of ovarian cancer based on miniPDX animal models

Dan SU,Yi LIU,Manman CUI,Nian YANG,Yu HUANG,Wenjing HE()   

  1. Department of Gynecology and Obstetrics,Sichuan Provincial People’s Hospital,Sichuan Academy of Medical Sciences,Chengdu 610072,China
  • Received:2020-09-05 Online:2021-05-28 Published:2021-05-28
  • Contact: Wenjing HE E-mail:104982648@qq.com

摘要: 目的

建立迷你人源性肿瘤移植(miniPDX)动物模型,筛选敏感上皮性卵巢癌(EOC)患者化疗方案并评价效果,为实现EOC个体化药物治疗提供依据。

方法

选取首次诊断为EOC并进行肿瘤细胞减灭术的患者22例作为药敏组,22例患者均同意进行miniPDX试验并签署相关同意书;另选取同期治疗并基本情况匹配的41例EOC患者作为对照组。药敏组采用患者肿瘤组织制成细胞悬液装入胶囊,并植入裸鼠皮下建立miniPDX模型。采用不同化疗药物治疗裸鼠后取出胶囊,CellTiter- Glo荧光细胞活力测定法测定胶囊中肿瘤细胞增殖率,选用细胞增殖率最低的方案对患者进行化疗。对照组采用紫杉醇+卡铂或紫杉醇+顺铂化疗方案。评价2组患者的疗效和不良反应发生率。将2组患者肿瘤组织病理切片进行CK7、WT-1、p16、p53、Ki-67和配对盒基因8抗原(PAX-8)免疫组织化学染色,分析其阳性结果与患者对含铂化疗敏感性之间的关系。

结果

药敏组22例患者中,14例完全缓解(CR),4例部分缓解(PR),总缓解率(ORR)为81.8%(18/22);对照组41例患者中,13例CR,14例PR, ORR为65.9%(27/41),药敏组患者ORR高于对照组(P<0.05)。2组患者的年龄、病理类型和分期等临床特征比较差异无统计学意义(P>0.05)。药敏组和对照组患者不良反应发生率比较差异无统计学意义(P> 0.05)。免疫组织化学检测,p16、p53、Ki-67和PAX-8阳性铂敏感患者百分率高于p16、p53、Ki-67和PAX-8阴性铂敏感患者(P<0.05),CK7和WT-1阳性铂敏感患者百分率与CK7和WT-1阴性者铂敏感患者比较差异无统计学意义(P>0.05)。

结论

根据miniPDX动物模型筛选EOC化疗方案可提高EOC患者治疗效果;p16、p53、Ki-67和PAX-8阳性表达可预测EOC患者的铂敏感。

关键词: 卵巢肿瘤, 人源性肿瘤移植动物模型, 化疗敏感性, 个体化治疗, 预后

Abstract:

Objective: To establish the mini patient-derived xenograft (miniPDX) animal models and screen the sensitive chemotherapy regimens of epithelial ovarian cancer patients and evaluate the clinical effect, and to provide the basis for the individualized EOC treatment.

Methods

A total of 22 patients diagnosed with EOC for the first time and underwent cytoreductive surgery were regarded as drug susceptibility group,and the patients agreed to take the miniPDX trial and signed the relevant consent forms. In addition, 41 EOC patients treated at the same time, whose basic conditions were matched with the patients in drug susceptibility group, were selected as control group. The tumor tissue of the patients in drug susceptibility group was used to get the cell suspension and encapsulated,and were implanted under the skin of nude mice to establish the miniPDX models. The mice were treated with different chemotherapeutic drugs for a week, then the capsules were taken out. The proliferation rates of the tumor cells in the capsules were determined by CellTiter-Glo fluorescent cell viability assay. The chemotherapy regiment with the lowest proliferation rate was selected to treat the patients.The patients in control group were given paclitaxel + carboplatin or paclitaxel + cisplatin chemotherapy regiment.The efficacies and the incidences of adverse reactions of the patients in two groups were evaluated. In addition, the tumor sections of the patients in two groups were stained with immunohistochemical assay of CK7, WT-1, p16, p53, Ki-67 and paired box protein-8(PAX-8),and the relationships between their positive results and the sensitivities of the patients to platinum-combined chemotherapy were analyzed.

Results

Among the 22 patients in drug susceptibility group, 14 patients were complete remission (CR),and 4 patients were partial remission (PR),and the overall remission rate (ORR) was 81.8%(18/22); among the 41 patients in control group,13 patients were CR, and 14 patients were PR, the ORR was 65.9% (27/41); the ORR of patients in drug susceptibility group was higer than that in control group (P<0.05). There were no significant differences in age, pathological type and stage of the patients between two groups (P>0.05). There were no significant differences in the incidences of adverse reactions of the patients between two groups (P>0.05). The results of immunohistochemistry indicated that the percentages of platinum-sensitive patients with p16, p53, Ki-67, and PAX-8 positive were significantly higher than the patients with p16, p53, Ki-67, and PAX-8 negative (P<0.05), and there were no significant differences between the percentages of platinum-sensitive patients with CK7 and WT-1 positive and the patients with CK7 and WT-1 negative (P>0.05).

Conclusion

To screen EOC chemotherapy regimens based on miniPDX animal model can improve the therapeutic efficacy of EOC patients; p16, p53, Ki-67, and PAX-8 positive expression can predict the platinum sensitivity of the EOC patients .

Key words: overian neoplasms, mini patient-derived xenograft animal model, chemosensitivity, individualized therapy, prognosis

中图分类号: 

  • R737.33