【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(duì)卵巢癌細(xì)胞SKOV3種群恢復(fù)的影響，并觀察該兩種細(xì)胞毒制劑分次給藥對(duì)復(fù)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(duì)SKOV3細(xì)胞凋亡與種群恢復(fù)的影響；并用CCK-8法分別測(cè)定各處理組在第7天（D7）及D21的吸光度值（Optical density，OD）。2.對(duì)20例復(fù)發(fā)性鉑類耐藥和難治性卵巢癌患者進(jìn)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(xué)檢查及CA125的變化情況，評(píng)估這部分患者對(duì)該方案的化療反應(yīng)性，探討該方案的臨床應(yīng)用價(jià)值。 結(jié)果：11.1CDDP單次或分次給藥對(duì)SKOV3的凋亡與種群恢復(fù)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(xì)胞的種群恢復(fù)（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(fù)發(fā)性鉑類耐藥和難治性卵巢癌患者對(duì)CDDP90mg/m2分為D1, D2, D3+PTX175mg/m2分為D1, D8化療方案的反應(yīng)性，結(jié)果提示反應(yīng)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(yīng)為骨髓抑制和胃腸道反應(yīng)，積極對(duì)癥處理的后，患者對(duì)此方案耐受性良好。 結(jié)論：細(xì)胞學(xué)實(shí)驗(yàn)結(jié)果提示CDDP聯(lián)合PTX分次給藥可明顯抑制卵巢癌SKOV3細(xì)胞的種群恢復(fù)。臨床中，，對(duì)于復(fù)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(yīng)性，但具體機(jī)理及對(duì)臨床患者生存的改善需要進(jìn)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(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.31

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