Herget G W, Neuburger M, Adler C P
Department of Thoracic Surgery, University of Freiburg, Freiburg i. Br., Germany.
Ann Diagn Pathol. 2000 Feb;4(1):11-6. doi: 10.1016/s1092-9134(00)90004-2.
Chondrosarcoma is the second most frequent primary malignant tumor of bone. Many of these tumors represent histopathologic borderline cases. In this study, DNA ploidy status, 2c deviation index (2cDI), and DNA malignancy grade (DNA-MG; based on the variation of nuclear DNA content of tumor cells around the normal DNA [2c] peak) were examined for their diagnostic and prognostic value in comparison with conventional histopathologic grading. Twenty-two paraffin-embedded samples were available for histopathologic investigation and for quantitative cytophotometric DNA determination of Feulgen-stained nuclei. Clinicopathologic parameters and prognosis were analyzed over a maximum follow-up period of 252 months. Nineteen of 22 (86%) chondrosarcomas showed aneuploid DNA content. 2cDI (r =.58, P <.01) and DNA-MG (r =.58; P <.01) correlate with the histopathologic grading. Significant correlation between the 2cDI (P <.01) and DNA-MG (P <.025) and the overall survival was found. Ploidy did not influence the overall survival rate. In metastasis-free patients, the 2cDI and DNA-MG gave better prognostic information than conventional histopathologic grading. When patients developed metastasis, however, histopathologic grading was the prognostic parameter of choice. Cytometric DNA measurement provide additional objective information regarding the diagnosis and prognosis of chondrosarcomas, even more than that obtained by conventional histopathologic grading, and may be helpful in planning the treatment.
软骨肉瘤是第二常见的原发性骨恶性肿瘤。这些肿瘤中有许多属于组织病理学上的临界病例。在本研究中,对DNA倍体状态、2c偏差指数(2cDI)和DNA恶性度分级(DNA-MG;基于肿瘤细胞核DNA含量围绕正常DNA[2c]峰值的变化)进行了检测,并与传统组织病理学分级相比,评估其诊断和预后价值。22份石蜡包埋样本可用于组织病理学研究以及对经福尔根染色的细胞核进行定量细胞光度法DNA测定。在最长252个月的随访期内分析临床病理参数和预后。22例软骨肉瘤中有19例(86%)显示非整倍体DNA含量。2cDI(r = 0.58,P < 0.01)和DNA-MG(r = 0.58;P < 0.01)与组织病理学分级相关。发现2cDI(P < 0.01)和DNA-MG(P < 0.025)与总生存率之间存在显著相关性。倍体不影响总生存率。在无转移患者中,2cDI和DNA-MG比传统组织病理学分级能提供更好的预后信息。然而,当患者发生转移时,组织病理学分级是首选的预后参数。细胞光度法DNA测量为软骨肉瘤的诊断和预后提供了额外的客观信息,甚至比传统组织病理学分级获得的信息更多,并且可能有助于制定治疗方案。