DETECTION OF MULTI-DRUG RESISTANCY IN MALIGNANT BONE AND SOFT TISSUE TUMORS BY ADRIAMYCIN BINDING ASSAY

在本研究中，作者首先建立了阿霉素结合试验（ABA）的体内检测方法，该方法在培养的细胞系中不仅可以快速检测阿霉素（ADR）的敏感性，还可以检测多种抗癌药物的敏感性；其次，研究了阿霉素结合率与人骨和软组织肿瘤化疗的临床或组织学效果之间的关系。用胶原酶从新鲜活检材料中分离活肿瘤细胞，用10ug/ml ADR孵育30min。然后用双醋酸荧光素（FDA）对活细胞进行染色。荧光显微镜下观察细胞核中有ADR荧光的活细胞对ADR敏感，细胞核中无ADR荧光的活细胞对ADR耐药。%AB表示所有活细胞中敏感细胞的频率。对44例患者进行了分析。在大多数原发肿瘤化疗后复发或转移，或原发肿瘤诊断时有转移的患者中，%AB小于80%。这强烈提示低AB百分比的肿瘤具有多重耐药。11例原发肿瘤无转移且既往化疗的患者中，术前化疗后，4例%AB > 80%的患者对化疗组织学敏感，其余7例%AB < 80%的患者除1例耐药外，其余4例%AB < 80%。结果表明，%AB与化疗效果有良好的相关性。因此，作者认为，ABA是一种优秀的化疗敏感性试验，可用于临床，因为它能够比以往报道的其他化疗敏感性试验更快、更准确地预测化疗敏感性。

In this study, the author first, developed in vivo method of adriamycine Binding Assay (ABA) which has been proved to be able to quickly detect sensitivity not only to adriamycine (ADR) also to multi-anticancer drugs in cultured cell lines and secondly, investigated relationship between adriamycin binding ratio and clinical or histological effect of chemotherapy in human bone nad soft tissue tumors. Living tumor cells were isolated from fresh biopsied materials with collagenase and incubated with 10ug/ml ADR for 30 min. Only living cells were then stained with fluorescein diacetate (FDA). Under observation with fluorescence microscope, the living cells with ADR fluorescence in nucleus were evaluated to be sensitive to ADR,but ones without ADR were resistant. %AB showed frequency of sensitive cells in all of the living cells measured. Fourty-four patients were analyzed. In most of the patients with recurrence or metastasis after chemotherapy to primary tumor, or with metastatic disease at diagnosis of primary tumor, %AB was less than 80%. This strongly suggests that tumors with low %AB are multi-drug resistant. Of 11 patients with primary tumor lesion without metastasis and any kind of previous chemotherapy, 4 with %AB more than 80% were histologically sensitive to chemotherapy after preoperative chemotherapy, whereas remaining 7 with %AB less than 80% except one were resistant. It also shows that %AB is correlated with chemotherapy effect well. The author, therefore concluded that ABA is one of the excellent chemosensitivity tests and avalable to clinical usage, because it is able to predict sensitivity to chemotherapy more quickly and accurately than other chemosensitivity tests previously reported.