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目的 探讨白血病细胞体外药敏试验的临床意义及从敏感性和耐药性两个不同侧面，研究两者内在联系。方法 采用ＭＴＴ法对２７例急性白血病患者的白血病细胞进行了Ａｒａ－Ｃ、ＤＮＲ、Ｈａｒ、ＭＩＴ、ＶＰ１６、ＶＭ２６、ＶＣＲ及ＨＣ等８ 种常用化疗药物的体外敏感试验以及用反转录－聚合酶链反应（ＲＴ－ＰＣＲ）方法检测了２２ 例患者多药耐药基因ｍ ｄｒ１ 的表达情况。结果 回顾性研究显示ＭＴＴ法体外药敏试验结果与临床疗效的总符合率为７７．３％ ，阳性符合率６１．５％ ，阴性符合率１００％ ，灵敏度１００％ ，特异度６４．３％ 。结论 ＭＴＴ法有一定的临床预测价值，是辅助临床用药选择的实验检测。ＭＤＲ相关药物ＤＮＲ、Ｈａｒ、ＭＩＴ、ＶＰ１６ 及ＶＭ２６ 体外药敏结果与ｍ ｄｒ１ 表达水平无相关性，提示可能存在其它的耐药机制。
Objective To explore the clinical significance of in vitro drug susceptibility testing of leukemia cells and to study the intrinsic links between sensitivity and drug resistance. Methods MTT assay was used to detect the in vitro sensitivity of 8 commonly used chemotherapeutic agents, including Ara-C, DNR, Har, MIT, VP16, VM26, VCR, and HC, in 27 leukemia cells from patients with acute leukemia and reverse transcription polymerase. The expression of multidrug resistance gene mdr1 was detected in 22 patients by chain reaction (RT-PCR). Results Retrospective studies showed that the overall coincidence rate of the in vitro drug susceptibility test results and clinical efficacy of MTT assay was 77.3%, the positive coincidence rate was 61.5%, the negative coincidence rate was 100%, the sensitivity was 100%, and the specificity was 64.3%. Conclusion The MTT method has certain clinical predictive value and is an experimental test for the selection of adjuvant clinical drugs. There was no correlation between the in vitro susceptibility of MDR-related drugs DNR, Har, MIT, VP16 and VM26 and the expression level of m dr1, suggesting that there may be other drug resistance mechanisms.