The quartz crystal microbalance (QCM) was used to construct a piezoelectric biosensor utilizing rat liver epithelial cells (WB F344) and lung melanoma cells (B16F10) as biorecognition elements. The cells adhered on the gold surface modified by either hydrophobic polystyrene or fibronectin. The simultaneous monitoring of changes in the resonant frequency Delta f and the resistance Delta R corresponded with the mass and viscoelastic properties of the adhered cells. In addition, the bound cells were stained using fluorescent probes to evaluate their viability on the non-transparent gold surface. Furthermore, this piezoelectric biosensor was used for monitoring of drug-induced apoptosis initiated by micromolar concentrations of alpha-tocopherol amidomalate (alpha-TAM), a potential anticancer drug. The characteristic features of apoptosis as shrinkage and disintegration of cell-cell contacts could be monitored by QCM. The decrease of frequency and increase of resistance characterized gradual death of cells that was confirmed by fluorescence microscopy. The results indicate that the piezoelectric biosensor can be used for the real-time study of the cell adhesion and the screening of biologically active drugs affecting cellular behaviour. (C) 2012 Elsevier B.V. All rights reserved.