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顺铂治疗后影响人类手术肿瘤标本中铂浓度的因素。

Factors affecting platinum concentrations in human surgical tumour specimens after cisplatin.

作者信息

Stewart D J, Molepo J M, Green R M, Montpetit V A, Hugenholtz H, Lamothe A, Mikhael N Z, Redmond M D, Gadia M, Goel R

机构信息

Ontario Cancer Treatment and Research Foundation, Ottawa Regional Cancer Centre, Canada.

出版信息

Br J Cancer. 1995 Mar;71(3):598-604. doi: 10.1038/bjc.1995.116.

Abstract

We assessed factors which affect cisplatin concentrations in human surgical tumour specimens. Cisplatin 10 mg m-2 was given i.v. to 45 consenting patients undergoing surgical resection of neoplasms, and platinum was assayed in resected tumour and in deproteinated plasma by flameless atomic absorption spectrophotometry. By multiple stepwise regression analysis of normalised data, patient characteristics that emerged as being most closely associated (P < 0.05) with tumour platinum concentrations (after correcting for associations with other variables) were tumour 'source' [primary brain lymphomas, medulloblastomas and meningiomas ('type LMM') > 'others' > lung cancer > head/neck cancer > gliomas) or tumour 'type' (LMM > brain metastases > extracerebral tumours > gliomas), serum calcium and chloride (positive correlations) and bilirubin (negative). Tumour location (intracranial vs extracranial) did not correlate with platinum concentrations. If values for a single outlier were omitted, high-grade gliomas had significantly higher platinum concentrations (P < 0.003) than low-grade gliomas. For intracranial tumours, the computerised tomographic scan feature that correlated most closely with platinum concentrations in multivariate analysis was the darkness of peritumoral oedema. Tumour source or type is a much more important correlate of human tumour cisplatin concentrations than is intracranial vs extracranial location. Serum calcium, chloride and bilirubin levels may affect tumour cisplatin uptake or retention. CT scan characteristics may help predict cisplatin concentrations in intracranial tumours.

摘要

我们评估了影响人类手术切除肿瘤标本中顺铂浓度的因素。对45例同意接受肿瘤手术切除的患者静脉注射10mg/m²顺铂,采用无火焰原子吸收分光光度法测定切除肿瘤组织和脱蛋白血浆中的铂含量。通过对标准化数据进行多元逐步回归分析,在校正与其他变量的关联后,与肿瘤铂浓度最密切相关(P<0.05)的患者特征为肿瘤“来源”(原发性脑淋巴瘤、髓母细胞瘤和脑膜瘤(“LMM型”)>“其他”>肺癌>头颈部癌>胶质瘤)或肿瘤“类型”(LMM>脑转移瘤>脑外肿瘤>胶质瘤)、血清钙和氯(正相关)以及胆红素(负相关)。肿瘤位置(颅内与颅外)与铂浓度无关。如果剔除单个离群值,高级别胶质瘤的铂浓度显著高于低级别胶质瘤(P<0.003)。对于颅内肿瘤,在多变量分析中与铂浓度最密切相关的计算机断层扫描特征是瘤周水肿的密度。与颅内与颅外位置相比,肿瘤来源或类型与人类肿瘤顺铂浓度的相关性更为重要。血清钙、氯和胆红素水平可能影响肿瘤对顺铂的摄取或潴留。CT扫描特征可能有助于预测颅内肿瘤中的顺铂浓度。

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