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Objective: The aim of the study was to establish an arsenic trioxide(ATO)-resistant cell line of human gallbladder carcinoma,GBC-SD/ATO,and to analyze the differential expressions of its apoptosis-associated genes,so as to investigate a correlation between ATO induced resistance of gallbladder carcinoma and expressions of apoptosis associated genes.Methods: The resistant call line was obtained in vitro by culture of human gallbladder carcinoma cell line GBC-SD with increasingly stepwise concentrations of ATO.The sensitivities of GBC-SD cells and GBC-SD/ATO cells to ATO were determined by MTT assay respectively,cDNA microarray containing 458 apoptosis-related human genes was used to compare the gene expression profiles of GBC-SD/ATO cells and corresponding sensitive cell line GBC-SD.Results: GBC-SD/ATO cell line was established successfully after 8 months of exposure to increasing concentrations of ATO.Compared with the parental cell line,GBC-SD/ATO was 13.6 times more resistant to ATO of the 458 apoptosis-related genes,17 genes were detected having > 2-fold difference of expression between the GBC-SD/ATO and GBC-SD cells,with 6 genes up-regulated and 11 genes down-regulated in GBC-SD/ATO cells.Conclusion: The 17 genes involved in the apoptosis pathway might be relevant to the resistance of GBC-SD/ATO cells to ATO,suggesting that the modulation of expression of apoptosis-related genes may be a main mechanism of acquired resistance in GBC-SD/ATO.