恶性骨肿瘤化疗药物敏感性研究

目的　分析恶性骨肿瘤化疗药物敏感性和多药耐药性 ,为制定敏感的个体化化疗方案提供依据。　方法　取恶性骨肿瘤新鲜标本 3 2例 (骨肉瘤 2 0例 ,其它恶性肿瘤 12例 ) ,运用流式细胞术检测化疗药物作用后的瘤细胞凋亡情况及其P170蛋白表达 ,分析其化疗敏感性和耐药性。结果　不同化疗药物作用后的骨肉瘤细胞凋亡百分比分别为 :甲氨喋呤 ( 3 0 5 0± 10 2 2 ) % ,阿霉素( 2 6 2 8± 9 3 5 ) % ,丝裂霉素 ( 2 3 11± 7 3 8) % ,足叶乙甙 ( 18 17± 6 14 ) % ,长春新碱 ( 4 4 4± 2 5 5 ) % ,环磷酰胺 ( 1 2 2± 0 5 9) %。P170蛋白表达较高者化疗敏感性均较低。　结论　流式细胞术分析化疗药物作用后的恶性骨肿瘤细胞凋亡及其P170蛋白表达 ,对预测肿瘤的化疗敏感性和耐药性有一定意义。

Flow cytometry for testing chemosensitivity of malignant bone tumors

OBJECTIVE: To study chemosensitivity and multidrug resistance of malignant bone tumors and to make an individual protocol of chemotherapy with sensitive antitumor agents. METHODS: Apoptosis induced by MTX, ADM, MMC, VP-16, VCR and CTX, and chemosensitivity in 32 fresh specimens of malignant bone tumors were analyzed by flow cytometry (FCM) and quantitative immunofluorescence. The expression of P-glycoprotein (P170) in the specimen and the relation between P170, multidrug resistance, and chemosensitivity were detected. RESULTS: The rate of apoptosis was significantly different in malignant bone tumor cells treated with different drugs: MTX (30.50 +/- 10.22)%, ADM (26.28 +/- 9.35)%, MMC (23.11 +/- 7.38)%, VP-16 (18.17 +/- 6.14)%, VCR (4.44 +/- 2.55)%, and CTX (1.22 +/- 0.59)%. The individual variation of cell apoptosis was prominent in the specimens of same pathological type treated with same agent. There was lower chemosensitivity in the malignant bone tumors with a high expression of P170. CONCLUSIONS: Chemosensitivity testing by flow cytometry is a simple, quick and sensitive assay. Quantitative analysis of expression of P170 could be used to predict multidrug resistance and its chemosensitivity of malignant bone tumors.