目的探讨肿瘤体外药敏试验三磷酸腺苷生物荧光法(ATP-TCA)在恶性实体瘤化疗中的应用。方法采用ATP-TCA技术对23例小儿恶性实体瘤(其中肾母细胞瘤8例,恶性生殖细胞瘤6例,神经母细胞瘤5例,肝母细胞瘤4例)进行药敏检测,测定其对长春新碱(VCR)、放线霉素D(ACTD)、多柔比星(ADM)、依托泊苷(VP-16)、丝裂霉素(MMC)、卡铂(KB)、羟基喜树碱(HCPT)、顺铂(CDDP)等化疗药物的体外敏感性。结果 1例神经母细胞瘤标本因细胞数少,放弃培养,余22例标本顺利完成检测,可评估率为95.65%。化疗药物对小儿恶性实体瘤细胞的杀伤作用具有较强的个体差异性,如肾母细胞瘤对ACTD、VCR+ACTD较敏感,肝母细胞瘤及恶性生殖细胞瘤对ACTD较敏感,神经母细胞瘤的耐药率高,HCPT对肾母细胞瘤敏感性较差,但对其他3种实体瘤体外总有效率为57.14%。结论 ATP-TCA技术是一种灵敏、可靠的肿瘤细胞敏感试验方法,可用于指导临床小儿恶性实体瘤化疗药物的筛选。 Objective To investigate the in vitro drug sensitivity test of adenosine triphosphate biofluorescence (ATP-TCA) in malignant solid tumor chemotherapy. Methods 23 cases of malignant solid tumors in children (including 8 cases of nephroblastoma, 6 cases of malignant germinoma, 5 cases of neuroblastoma and 4 cases of hepatoblastoma) were detected by ATP-TCA. VCR, ACTD, ADM, VP-16, MMC, carboplatin (KB), hydroxy-hi (HCPT), cisplatin (CDDP) and other chemotherapy drugs in vitro susceptibility. Results One patient with neuroblastoma had fewer cells and abandoned the culture. The remaining 22 specimens were successfully tested, with an assessable rate of 95.65%. Chemotherapy drugs on children with malignant solid tumor cells have strong individual-specific differences, such as nephroblastoma ACTD, VCR + ACTD more sensitive, hepatoblastoma and malignant germ cell tumors are more sensitive to ACTD, neuroblasts HCPT is less sensitive to nephroblastoma, but the total effective rate of the other three kinds of solid tumors is 57.14%. Conclusion ATP-TCA is a sensitive and reliable tumor cell sensitivity test method that can be used to guide clinical screening of malignant solid tumor chemotherapy drugs in children.