| Objective: To explore the feasibility of the ATP-tumor chemosensitivity assay (ATP-TCA) applied in selection of cytotoxic drug in malignant pediatric solid tumor; To evaluate ex vivo sensitive rate of specimens of fresh malignant pediatric solid tumor to five cytotoxic drugs and one combined scheme; To analyse the relationship between the expression of P-glycoprotein(P-gp) and ATP-TCA and select the effective drug for clinic. Method: ATP-TCA was used to detect the sensitive rate of 34 specimens of fresh pediatric solid tumor to those cytotoxic drugs as follows: vincristin(VCR),cisplatin(CDDP),hydroxycamptothecin (HCPT),doxorubicin(ADM) , etoposide(VP-16) , dactinomycin (ACTD). Expressions of P-gp were examined in paraffin sections from 17 resected specimens of wilm,s tumor patients by two-step immunohistochemical staining and then analysis the relation of ATP-TCA and P-gp . Result: â‘ Evaluable test results were chieved in 31 of 34 specimens, the evaluability rate of ATP-TCA was 91.17%. â‘¡The result of ex vivo sensitive rate is listed follows: wilm's tumor: VCR+ ACTD (94.12%),ACTD(82.35%),ADM(52.94%),VCR (47.06%),VP-16 (29.41%),HCPT(29.41%). gonioma: CDDP+ VP-16(85.71%),ACTD (85.71%),VP-16(71.43%),HCPT (57.14%),VCR (42.86%),CDDP (28.57%). Whereas, the neuroblastoma is resistance to the cytotoxic drugs. â‘¢The expression of P-gp was concordant with the resistance to ADM and VCR(P<0.05),but not with that to ACTD,VP-16and HCPT(P>0.05).â‘£HCPT has a low ex vivo sensitive rate in wilm,s tumor(29.41%),but it reach to a high rate of 64.29% in all the other 14 pediatric solid tumors. Conclusion: â‘ ATP-TCA is a sensitive,reliable and standardization method for the chemotherapeutic agents screening of pediatric malignant solid tumor. â‘¡The ex vivo sensitive rates of VCR+ACTD and ACTD were high in wilm,s tumor,which tally with the clinical application. â‘¢The positive expression of P-gp might be correlated with the resistance to ADM and VCR in wilm,s tumor.
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