0引言骨肉瘤为临床最常见的原发恶性骨肿瘤,好发于青少年。目前的治疗是新辅助化疗保护下的保肢治疗,因此化疗的敏感性对其预后有着重要的影响,而耐药是临床化疗失败常见的原因。药物的摄取和转运障碍、药物的活化障碍、DNA损伤修复能力增强、细胞周期阻滞与凋亡失衡和凋亡通路 0 Introduction Osteosarcoma is the most common primary malignant bone tumor in clinic and occurs in adolescents. The current treatment is limb salvage under the protection of neoadjuvant chemotherapy, so the sensitivity of chemotherapy has an important impact on its prognosis, and drug resistance is a common cause of clinical chemotherapy failure. Drug uptake and transport disorders, drug activation disorders, DNA damage repair capacity increased, cell cycle arrest and apoptosis imbalance and apoptosis pathway