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

在本研究中，作者首先建立了体内阿霉素结合试验(ABA)的方法，该方法不仅能快速检测培养细胞对阿霉素(ADR)的敏感性，而且能快速检测多种抗癌药物的敏感性，并探讨阿霉素结合率与人骨软组织肿瘤化疗临床及组织学疗效的关系。用胶原酶从新鲜活检材料中分离出活的肿瘤细胞，用10ug/mlADR孵育30min。然后用二乙酸荧光素(FDA)对活细胞进行染色。在荧光显微镜下观察，细胞核内有ADR荧光的活细胞对ADR敏感，而无ADR的活细胞对ADR敏感。%AB显示所有测量的活细胞中敏感细胞的频率。对44例患者进行了分析。大多数原发灶化疗后复发或转移的患者，或原发灶确诊时有转移灶的患者，%AB<80%。这有力地表明低AB的肿瘤是多药耐药的。11例原发灶无转移且有化疗史的患者中，4例组织学%AB>80%的患者术前化疗后对化疗敏感，其余7例%AB<80%的患者除1例外，其余均为耐药。%AB与化疗效果有较好的相关性。因此，作者认为ABA比以往报道的其他药敏试验更能快速、准确地预测化疗敏感性，是一种可供临床使用的优良药敏试验。

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.