ABSTRACT
Objective To evaluate the efficacy of mitomycin (MMC) intravesical chemotherapy for superficial bladder carcinoma by in vitro chemosensitivity using histoculture drug response assay (HDRA).Methods Forty-one cases of superficial bladder transitional cell carcinoma(TCC) were obtained,including 30 males and 11 females with mean age of 55 years.Of them,10 cases were Ta and 31 were T1 according to TNM stage system (UICC 2002) while 9 cases were G1,22 were G2 and 10 were G3 (WHO1973).All cases had no chemotherapy history before operation and were operated to retain bladder.Tumor specimens were cultured by three-dimensional histoculture.HDRA with im-proved MTT assay was utilized for chemosenstivity test of MMC with 1 g/L concentration and 2 hours exposure.Growth inhibition rate (GI) exceeding 70% was defined as high-sensitive while less than 50% GI was defined as insensitive,others were moderate-sensitive.All cases were performed standard intravesical chemotherapy with MMC 40 mg plus 40 mt saline.Every case was followed up every 3 months.The patients were followed up for 5 years or untill recurrence.Results The MMC chem-osensitivity was different among 41 patients.Thirteen cases were insensitive including 1 of Ta,12 of T1 (P=0.009) and 1 of G1,7 of G2,5 of G3(P=0.101).Total recurrence rate was 39%(16/41) af-ter 3 to 5 years follow-up.There were 1 of Ta,15 of T1 (P=0.059) and 10 of G2 6 of G3 (P=0.016).Insensitive group recurrence rate was 77% (10/13) while sensitive group was 21% (6/28,P= 0.004).Patients in sensitive group showed a longer median time(49.2 months) than patients in insen-sitive group (16.5 months,P<0.001) according to Kaplan-Meier analysis with Log-rank test.The MMC chemosensitivity was independent prognostic factor examed by Cox regression analysis (P= 0.008).There was a 78% correlation rate of chemosensitivity by HDRA to clinical effect of MMC in-travesical chemotherapy.Conclusion HDRA could evaluate MMC intravesical chemotherapy for su-perficial bladder TCC,improve therapeutic effect and lower tumor recurrence rate.
ABSTRACT
Objective To evaluate the diagnostic valu e of ~131I-MIBG adrenomedullary scintigraphy for high blood cat echolamine. Methods 96 cases of high blood catecholamine and 197 cases of other diseases were screened with ~131I-metaiodo benzylguanidine(MIBG) adrenomedullary scintigraphy. Results 56 cases of the total 60 cases of pheochromocytoma and 33 cases of the total 36 cases of adrenomedullary hyperplasia showed positive image. The positiv e rate were 93.3% and 91.7% respectively. 138 cases of primary hypertension, 4 9 cases of adrenal and other organic tumor, 4 cases of pheochromocytoma befor e operation, 10 cases of cured pheochromocytoma after resection and 3 cases of adrenomedullary hyperplasia all showed negative image. The total positive rate for high blood catecholamine was 92.7%, which was much higher than other method s, such as biochemical assay, type B ultrasound, computer tomography and magneti c resonance image. Conclusions ~131I-MIBG w as of great value for the locative and qualitative diagnosis of high blood catec holamine,especially for the silent, ectopic and multiple pheochromocytoma, the m etastatic malignant pheochromocytoma and adrenomedullary hyperplasia. It could be used for the differential diagnosis of high blood catecholamine from primary hypertension and other kinds of tumors.