Stratton J A, Kucera P R, Rettenmaier M A, Dobashi K, Micha J P, Braly P S, Berman M L, DiSaia P J
Gynecol Oncol. 1986 Nov;25(3):302-10. doi: 10.1016/0090-8258(86)90081-8.
Seventy-six patients with advanced ovarian cancer treated with cyclophosphamide, doxorubicin, and cisplatin (CAP) at 3-week intervals were tested for the response of their tumors to treatment with CAP in the subrenal capsule tumor implant assay. Thirty-four of the patients' tumors were assayed prospectively before clinical treatment and 33 were assayed retrospectively, after clinical treatment with CAP. Nine of the patients' tumors were assayed both prospectively and retrospectively. All of the patients underwent a tumor debulking laparotomy. Of the patients with clinically measurable residual disease, 17 had a partial response of at least 50% regression of disease, and 11 had a progression of disease. Of the patients with known residual but nonmeasureable disease, 7 had surgically verified complete responses, 8 at least 50% regression, and 23 had progression of disease: 10 had no evidence of disease clinically but had not had surgical confirmation. Twenty-six of the tumors were adenocarcinomas not otherwise specified (2 grade I, 2 grade II, and 22 grade III), 39 were serous adenocarcinomas (7 grade I, 9 grade II, and 23 grade III), 7 were endometrioid adenocarcinoma (all grade III), 3 were mucinous adenocarcinomas (1 each of grade I, II, and III) and 1 was an adenosquamous carcinoma (grade III). Thirty-four of the patients failed the therapy. The subrenal capsule (SRC) assay predicted 21 of these failures (4 prospective and 17 retrospective). Thirty-two of the patients responded to CAP chemotherapy. The SRC assay accurately predicted the clinical regression of the tumors of 22 of the patients (15 prospective and 7 retrospective). Second-look laparotomy confirmed 7 patients with no evidence of disease, 5 patients with minimal disease, and 5 patients with a greater than 50% reduction of their disease. The SRC assay predicted the response of all these patients except 2 with partial responses to chemotherapy. Thus, while the overall positive predictive value of the SRC assay in this study is 65%, it is 100% for those patients whose tumors respond completely and for those who have minimal residual disease after CAP chemotherapy.
76例晚期卵巢癌患者接受环磷酰胺、阿霉素和顺铂（CAP）治疗，治疗间隔为3周。这些患者的肿瘤在肾下囊肿瘤植入试验中接受了CAP治疗反应测试。34例患者的肿瘤在临床治疗前进行了前瞻性检测，33例在CAP临床治疗后进行了回顾性检测。9例患者的肿瘤同时进行了前瞻性和回顾性检测。所有患者均接受了肿瘤减瘤剖腹手术。在临床可测量残留疾病的患者中，17例疾病部分缓解，至少消退50%，11例疾病进展。在已知有残留但不可测量疾病的患者中，7例经手术证实完全缓解，8例至少消退50%，23例疾病进展：10例临床无疾病证据，但未得到手术确认。26例肿瘤为未另行指定的腺癌（2例I级，2例II级，22例III级），39例为浆液性腺癌（7例I级，9例II级，23例III级），7例为子宫内膜样腺癌（均为III级），3例为黏液性腺癌（I级、II级和III级各1例），1例为腺鳞癌（III级）。34例患者治疗失败。肾下囊（SRC）试验预测了其中21例失败（4例前瞻性和17例回顾性）。32例患者对CAP化疗有反应。SRC试验准确预测了22例患者肿瘤的临床消退（15例前瞻性和7例回顾性）。二次剖腹探查证实7例患者无疾病证据，5例患者疾病轻微，5例患者疾病减少超过50%。SRC试验预测了除2例化疗部分缓解患者外所有这些患者的反应。因此，虽然本研究中SRC试验的总体阳性预测值为65%，但对于肿瘤完全反应的患者以及CAP化疗后残留疾病轻微的患者，其阳性预测值为100%。
