Wang Shuang, Fan Na, Li Han, Li Yang, Hu Ping, Chen Dongliang, Jiang Xiaohong, Gao Lei, Yang Chenggang, Yang Dawei
Zhong Yuan Academy of Biological Medicine, Liaocheng People's Hospital, Liaocheng, China.
Deparment of Gastrointestinal Surgery, Liaocheng People's Hospital, Liaocheng, China.
Front Oncol. 2025 Jul 16;15:1596253. doi: 10.3389/fonc.2025.1596253. eCollection 2025.
The high incidence, substantial mortality, and marked heterogeneity in chemotherapy responses among gastrointestinal tumors accentuate the imperative for individualized treatment strategies. This study aims to evaluate the reliability and clinical significance of the histoculture drug response assay (HDRA) in predicting chemotherapy sensitivity and prognosis. Specifically, it focuses on Chinese patients diagnosed with gastrointestinal cancers.
This study enrolled 283 patients with gastrointestinal tumors, comprising 124 esophageal cancer cases, 92 gastric/cardia cancer cases, and 67 colorectal cancer cases. Immunohistochemistry was conducted to assess tumor structure integrity and the expression of Ki - 67, CD31, and E - cadherin before and after the HDRA assay. HDRA evaluated the efficacy and inhibition rates of single and combination chemotherapy regimens. Moreover, the effect of HDRA - guided treatment on patient survival was analyzed.
The results indicated that HDRA effectively preserved the three-dimensional structure and microenvironment of gastrointestinal tumors, as no significant changes were observed in the expression of Ki-67, CD31, or E-cadherin. Furthermore, combination regimens showed significantly higher efficacy and inhibition rates than single - agent therapies. Notably, platinum-based combination therapy was most effective in esophageal cancer. Survival analysis revealed that esophageal and gastric cancer patients receiving HDRA - sensitive regimens (HDRA group) had significantly longer disease - free survival (DFS) compared to those on non - sensitive regimens (N - HDRA group) and untreated patients. Cox regression analysis indicated that HDRA-guided treatment serves as a protective factor for DFS (hazard ratio, HR<1).
In summary, the HDRA assay represents a reliable assay for accurately evaluating chemotherapy regimens, thereby furnishing guidance for individualized treatment in gastrointestinal cancer patients.
胃肠道肿瘤的高发病率、高死亡率以及化疗反应的显著异质性凸显了个体化治疗策略的必要性。本研究旨在评估组织培养药物反应测定法（HDRA）在预测化疗敏感性和预后方面的可靠性及临床意义。特别关注诊断为胃肠道癌症的中国患者。
本研究纳入283例胃肠道肿瘤患者，包括124例食管癌患者、92例胃癌/贲门癌患者和67例结直肠癌患者。在HDRA测定前后进行免疫组织化学检测，以评估肿瘤结构完整性以及Ki-67、CD31和E-钙黏蛋白的表达。HDRA评估了单药和联合化疗方案的疗效及抑制率。此外，分析了HDRA指导治疗对患者生存的影响。
结果表明，HDRA有效保留了胃肠道肿瘤的三维结构和微环境，因为Ki-67、CD31或E-钙黏蛋白的表达未观察到显著变化。此外，联合方案的疗效和抑制率显著高于单药治疗。值得注意的是，铂类联合治疗在食管癌中最有效。生存分析显示，接受HDRA敏感方案（HDRA组）的食管癌和胃癌患者与接受非敏感方案（N-HDRA组）和未治疗患者相比，无病生存期（DFS）显著更长。Cox回归分析表明，HDRA指导治疗是DFS的保护因素（风险比，HR<1）。
总之，HDRA测定法是准确评估化疗方案的可靠方法，从而为胃肠道癌症患者的个体化治疗提供指导。
