Abstract
Objective: We evaluated the success rates and factors influencing the success rates of the Collagen Gel Droplet-Embedded Culture Drug Sensitivity Test (CD-DST) for pleural effusate in lung cancer patients with carcinomatous pleurisy.Materials and methods: Thirty-two patients with lung cancer having carcinomatous pleurisy were enrolled in this study between January 2014 and May 2017. Their pleural effusions were analysed by CD-DST, and the subjects were classified into two groups: successful cases and unsuccessful cases, based on whether the test was able to successfully determine drug sensitivity. We investigated whether the properties of the pleural effusate might influence the success rate of CD-DST. We observed that the CD-DST tended to have good success rates in patients with higher pH, higher percentage of lymphocytes, higher cell counts, and lower percentage of neutrophils in their pleural effusate. The red blood cell count was higher in the effusate of unsuccessful than successful cases.Conclusion: Our results suggest that the diagnostic success rates of CD-DST for pleural effusion from patients with lung cancer might improve by appropriate sample selection.
Highlights
Chemosensitivity tests for lung cancer have been developed in order to select the most effective drug prior to commencement of treatment
CD-DST was more likely to be successful in pleural fluid with a high pH, high lymphocyte ratio, low neutrophil ratio, and high total white cell count
There was no significant difference between the groups in terms of the levels of lactate dehydrogenase (LDH), carcinoembryonic antigen (CEA), albumin and total protein in pleural fluid (Figures 2f-l), or tumor histological type (Figure 3)
Summary
Chemosensitivity tests for lung cancer have been developed in order to select the most effective drug prior to commencement of treatment. The CD-DST is advantageous in that it requires a fewer number of cells, eliminates the effects of contamination by fibroblasts during the cell collection process, and allows evaluation of the physiological concentrations of the drugs. These features enable its use for evaluation of drug sensitivity with fluids such as pleural and pericardial fluids; the results generated might not be definitive, depending on the number of cells and type of specimens used [5]
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