卵巢癌中的细胞增殖：通过DNA标记指数测定的S期细胞分数（SPF）较流式细胞术测定的SPF具有更高的准确性，SPF和DNA倍体缺乏独立的预后能力，且SPF对肿瘤生长速率的影响有限。

Cell proliferation in ovarian carcinoma: superior accuracy of S-phase fraction (SPF) by DNA labeling index versus flow cytometric SPF, lack of independent prognostic power for SPF and DNA ploidy, and limited effect of SPF on tumor growth rate.

作者信息

Meyer J S, Gersell D J, Yim S

机构信息

Department of Pathology, St. Luke's Hospital, 232 South Woods Mill Road, Chesterfield, Missouri 63017, USA.

出版信息

Gynecol Oncol. 2001 Jun;81(3):466-76. doi: 10.1006/gyno.2001.6184.

DOI:10.1006/gyno.2001.6184

PMID:11371140

Abstract

OBJECTIVES

The goal of this work was to test the hypotheses that S-phase fraction (SPF) by DNA labeling index (SPF-LI) would predict the course of the disease for ovarian/peritoneal carcinomas and that SPF-LI would correlate better with pathologic classification and outcome than SPF by DNA flow cytometry (SPF-F).

METHODS

Tritiated thymidine (1985-1988) and bromodeoxyuridine (1988-1999) DNA labeling (SPF-LI) was evaluated in vitro on 178 tumors. Cellular DNA and SPF-F were measured flow cytometrically. During this time, 90% of ovarian/peritoneal tumors accessioned in surgical pathology were studied.

RESULTS

Tumors of low malignant potential (LMP, "borderline") had low SPF-LI (median = 1.2%). High-grade invasive carcinomas of various types and carcinosarcomas all had high SPF-LI (medians = 11.2-23.4%). Serous low-grade invasive carcinomas (median = 1.05) resembled LMP tumors. SPF-LI of ovarian carcinomas other than LMP tumors increased slightly as FIGO stage increased (P = 0.07). Survival of patients with high-grade ovarian carcinomas was not predicted by SPF-LI or SPF-F, nor was DNA ploidy predictive. SPF-LI produced tighter distributions for various tumor types than did SPF-F. Neither SPF nor DNA ploidy contributed to prediction of outcome when tumor type and stage were included in multivariate models. We calculated the mean cell loss rate of high-grade carcinomas to be 94%.

CONCLUSIONS

LMP ovarian/peritoneal tumors have low proliferation rates in contrast to high-grade carcinomas. Proliferation correlated with tumor type and stage, but neither it nor DNA ploidy predicted survival independently. Proliferation rate is growth limiting only when low. At higher levels cell loss limits growth. SPF-LI measures proliferation more accurately than SPF-F; SPF-F is not sufficiently reliable for clinical use.

摘要

目的

本研究旨在验证以下假设：通过DNA标记指数得出的S期细胞分数（SPF-LI）可预测卵巢/腹膜癌的疾病进程，且相较于通过DNA流式细胞术得出的SPF（SPF-F），SPF-LI与病理分类及预后的相关性更好。

方法

对178例肿瘤进行体外氚标记胸腺嘧啶核苷（1985 - 1988年）和溴脱氧尿苷（1988 - 1999年）DNA标记（SPF-LI）评估。通过流式细胞术测量细胞DNA和SPF-F。在此期间，对手术病理中90%的卵巢/腹膜肿瘤进行了研究。

结果

低恶性潜能（LMP，“交界性”）肿瘤的SPF-LI较低（中位数 = 1.2%）。各种类型的高级别浸润性癌和癌肉瘤的SPF-LI均较高（中位数 = 11.2 - 23.4%）。浆液性低级别浸润性癌（中位数 = 1.05）与LMP肿瘤相似。除LMP肿瘤外，卵巢癌的SPF-LI随国际妇产科联盟（FIGO）分期增加略有升高（P = 0.07）。SPF-LI或SPF-F均无法预测高级别卵巢癌患者的生存情况，DNA倍体也无预测价值。相较于SPF-F，SPF-LI使各种肿瘤类型的分布更紧密。当肿瘤类型和分期纳入多变量模型时，SPF和DNA倍体均无助于预测预后。我们计算出高级别癌的平均细胞丢失率为94%。