Summary A perifusion technique for microscopy with computerized detection of early changes in cell morphology during continuous perifusion was used to show that the geometry of cultured glioma cells (MG-251) changes rapidly when they are exposed to estramustine phosphate (EMP). When the cells were exposed to 20 or 40 mg 1-' EMP, cell volume projected cell area (PCA) rapidly increased. When the Na+, K+-ATPase blocker ouabain (100 ,umol 1-') was added to the EMP (40 mg 1-') perifusion, the acute EMP response was eradicated. When the PCA curve for ouabain alone was subtracted from the curve of combined ouabain and EMP perifusion, the resulting curve showed that ouabain completely blocked the EMP-induced increase in PCA. When the Na+, K+, Cl-co-transport inhibitors bumetanide (10 lmol 1-'), or furosemide (100 ,umol 1-'), were added to EMP (40 mg 1-'), the acute increase in PCA seen for EMP alone was also completely blocked. This study shows that inhibitors of ion transmembrane transport can modify EMP-induced cell volume increases. This may be of particular importance since the blockers have been found to interfere also with the cytotoxic function of EMP during cell culture. Thus, it is possible that cell volume changes could serve as a rapid technique for predicting the cytotoxic activity of antineoplastic drugs.Keywords: cell volume; cytotoxicity; estramustine; microperifusion; potassium flux An intact cell volume is known to be of critical importance for the preservation of cell functions, including growth and proliferation (Hoffman and Simonsen, 1989). Extensive studies on cell volume regulation in the last few years indicate that a wide variety of cells share common regulatory capacities, although a pronounced diversity exists between different cell types in the nature of the ion transport systems involved. It is well known that transmembrane fluxes of cations are part of important cell functions, such as maintenance of the membrane potential regulation, intracellular pH (DeWeer, 1985), and volume regulation in anisotonic media (Hoffman and Simonsen, 1989). Predictive tumour sensitivity tests have received increasing attention, and several different predictive cellular and animal systems have been developed with varying degree of success (Chapman et al, 1989). There is, thus, still a strong need for more effective predictive tests of drug sensitivity in clinical oncology.Estramustine phosphate (EMP), a cytotoxic nor-nitrogen mustard derivative of oestradiol 1 7p-phosphate, is generally accepted in the treatment of advanced prostatic carcinoma (Madajewics et al, 1980), and recently it has been shown to exert considerable cytotoxic effects on several glioma cell lines von Schoultz et al, 1990). In the present study, we have investigated the effect of bumetanide and furosemide, inhibitors of Na+, K+, Cl-co-transport, and ouabain, an inhibitor of Na+, K+-ATPase, on the cytotoxic effect of EMP. This was done by means of a new microscopic technique that provides the ability to follow early alterations in cell size an...