Berczi Cs, Bocsi J, Bartha I, Math J, Balazs Gy
1st Department of Surgery, University of Debrecen, Késmark str. 7/C., 4029, Debrecen, Hungary.
Anticancer Res. 2002 Nov-Dec;22(6B):3737-41.
A retrospective study was performed to measure the prognostic value of DNA ploidy status and proliferative index (PI) for survival in patients with rectal cancer.
Fifty-two patients underwent curative surgery for rectal carcinoma. Ten tumors were in Stage I, 25 cancers were in Stage II, and 17 of them were in Stage III. Using flow cytometry the nuclear DNA content of the tumor cells was measured.
There were 25 DNA diploid and 27 DNA aneuploid carcinomas. Aneuploid DNA content did not show higher occurrence in advanced tumors. The mean survival was 59 months in the case of DNA diploid carcinoma, while it was 47 months in the case of DNA aneuploid cancer. The mean PI of the DNA diploid cancers was 8%. The PI of DNA aneuploid tumors was 22%. High PI (PI > 10%) was observed in 32 carcinomas while low PI (PI < 10%) occurred in 20 cases. Patients with aneuploid DNA content and high PI had significantly worse survival compared to patients with diploid DNA content while low PI. Locoregional and distant metastases occurred more frequently in patients with aneuploid tumor. By univariate analysis, tumor size, lymph node involvement, DNA ploidy status and PI all correlated with prognosis. However, multivariate analysis showed that TNM stage and PI were the only significant prognostic factors for survival.
The survival and disease-free survival of patients with diploid DNA content was better compared to aneuploid cases. The results suggest that DNA ploidy status is important in determining the biological behaviour of rectal carcinomas, although the multivariate analysis did not prove its significant influence. The PI were independent negative prognostic factors for survival.
进行了一项回顾性研究，以评估DNA倍体状态和增殖指数（PI）对直肠癌患者生存的预后价值。
52例患者接受了直肠癌根治性手术。其中10例肿瘤为I期，25例为II期，17例为III期。采用流式细胞术检测肿瘤细胞的核DNA含量。
25例为DNA二倍体癌，27例为DNA非整倍体癌。非整倍体DNA含量在晚期肿瘤中并未显示出更高的发生率。DNA二倍体癌患者的平均生存期为59个月，而DNA非整倍体癌患者为47个月。DNA二倍体癌的平均PI为8%。DNA非整倍体肿瘤的PI为22%。32例癌观察到高PI（PI>10%），20例为低PI（PI<10%）。与DNA含量为二倍体且PI较低的患者相比，DNA含量为非整倍体且PI较高的患者生存期明显较差。非整倍体肿瘤患者局部和远处转移更常见。单因素分析显示，肿瘤大小、淋巴结受累情况、DNA倍体状态和PI均与预后相关。然而，多因素分析表明，TNM分期和PI是生存的唯一重要预后因素。
与非整倍体病例相比，DNA含量为二倍体的患者生存期和无病生存期更好。结果表明，DNA倍体状态在确定直肠癌的生物学行为中很重要，尽管多因素分析未证实其有显著影响。PI是生存的独立负性预后因素。
