Zeng Y L, Wang S D, Li Y R, Xue W S, Wang T, Tang Y T, Zheng H, Chen Z X, Lan J Q, Yan J
Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2023 Aug 25;26(8):780-786. doi: 10.3760/cma.j.cn441530-20221128-00499.
To investigate the risk factors for organoid culture failure in colorectal cancer. This was a retrospective observational study. Tumor specimens were obtained from 1130 patients with colorectal cancer who had undergone surgery or biopsy and had no other concurrent malignancies at Nanfang Hospital of Southern Medical University from December 2021 to November 2022. Organoid culture was performed on 1231 tumor tissue samples. Univariate analysis and multivariate logistic regression were used to analyze the factors that might have influenced the rate of successful organoid culture of colorectal cancer tissue samples. The median (range) duration of organoid culture was 7 (3-12) days. The overall rate of successful culture was 76.3% (939/1231). The rate of successful organoid cultures varied according to the sampling site, malignant ascites having the highest success rate (96.4%, 27/28), followed by liver metastases (83.1%, 54/65), lung metastases (8/10), primary tumors (76.0%, 816/1074), omental metastases (10/14), peritoneal metastases (61.5%, 16/26), ovarian metastases (3/5), and lymph node metastases (5/9). The difference in rates of successful organoid culture between primary tumors and malignant ascites was statistically significant (=0.012), whereas none of the other rates of successful organoid culture success differed significantly (all >0.05). The rate of successful organoid culture was 96.4% (27/28) for malignant ascites obtained by abdominal puncture, 76.5% (864/1130) for surgical specimens, and 65.8% (48/73) for endoscopic biopsies; these differences are statistically significant (χ=10.773, =0.005). The rate of successful organoid culture was 62.5% (40/64) in the neoadjuvant chemoradiotherapy group, which is significantly lower than in the non-adjuvant (76.9%, 787/1023) and chemotherapy groups (77.8%, 112/144) (χ=7.134, =0.028). Multivariate logistic regression analysis revealed that endoscopic biopsy (OR=0.557, 95%CI: 0.335-0.924, =0.024) and neoadjuvant chemoradiotherapy (OR=0.483, 95%CI: 0.285-0.820, =0.007) were independent risk factors for failure of organoid culture of colorectal cancer samples. Malignant ascites (OR=8.537, 95%CI:1.154-63.131,=0.036) and abdominal puncture (OR=8.294, 95% CI: 1.112-61.882, =0.039) were identified as independent protective factors. The rate of successful organoid culture was influenced by the sampling site, sampling method, and chemoradiotherapy. The rate of successful organoid culture was lower for endoscopic biopsies and in patients receiving preoperative neoadjuvant chemoradiotherapy, and higher for malignant ascites. We consider that culture of malignant ascites is preferable when peritoneal metastases are suspected.
探讨结直肠癌类器官培养失败的危险因素。这是一项回顾性观察研究。收集了2021年12月至2022年11月在南方医科大学南方医院接受手术或活检且无其他并发恶性肿瘤的1130例结直肠癌患者的肿瘤标本。对1231个肿瘤组织样本进行了类器官培养。采用单因素分析和多因素logistic回归分析可能影响结直肠癌组织样本类器官培养成功率的因素。类器官培养的中位（范围）持续时间为7（3 - 12）天。总体培养成功率为76.3%（939/1231）。类器官培养成功率因采样部位而异，恶性腹水的成功率最高（96.4%，27/28），其次是肝转移灶（83.1%，54/65）、肺转移灶（8/10）、原发性肿瘤（76.0%，816/1074）、网膜转移灶（10/14）、腹膜转移灶（61.5%，16/26）、卵巢转移灶（3/5）和淋巴结转移灶（5/9）。原发性肿瘤与恶性腹水的类器官培养成功率差异有统计学意义（=0.012），而其他类器官培养成功率之间差异均无统计学意义（均>0.05）。经腹穿刺获取的恶性腹水类器官培养成功率为96.4%（27/28），手术标本为76.5%（864/1130），内镜活检标本为65.8%（48/73）；这些差异有统计学意义（χ=10.773，=0.005）。新辅助放化疗组类器官培养成功率为62.5%（40/64），显著低于非新辅助组（76.9%，787/1023）和化疗组（77.8%，112/144）（χ=7.134，=0.028）。多因素logistic回归分析显示，内镜活检（OR = 0.557，95%CI：0.335 - 0.924，=0.024）和新辅助放化疗（OR = 0.483，95%CI：0.285 - 0.820，=0.007）是结直肠癌样本类器官培养失败的独立危险因素。恶性腹水（OR = 8.537，95%CI：1.154 - 63.131，=0.036）和经腹穿刺（OR = 8.294，95%CI：1.112 - 61.882，=0.039）被确定为独立保护因素。类器官培养成功率受采样部位、采样方法和放化疗影响。内镜活检及接受术前新辅助放化疗患者的类器官培养成功率较低，恶性腹水的成功率较高。我们认为，怀疑有腹膜转移时，培养恶性腹水是较好的选择。
