Baldetorp B, Fernö M, Fallenius A, Fallenius-Vecchi G, Idvall I, Olsson H, Sigurdsson H, Akerman M, Killander D
Department of Oncology, University Hospital, Lund, Sweden.
Cytometry. 1992;13(6):577-85. doi: 10.1002/cyto.990130605.
Measurements of DNA ploidy can be performed either with image cytometry (ICM) or flow cytometry (FCM); both methods provide independent prognostic information in primary breast cancer. The aim of the present investigation was to compare the two methods and to relate the findings to prognosis (median follow-up 42 months). Concordance in ploidy status (diploid, tetraploid, aneuploid) was obtained in 76% of the samples (168/222). When the fraction of S-phase cells (SPF) from FCM analysis was also taken into consideration, four different groups of samples were obtained (Flow I-IV), which were considered to correspond to the Auer classification (Auer I-IV) of DNA histograms obtained from image cytometry. Complete concordance between the two techniques now was 70% (155/222). Samples classified as Flow I (diploid or near-diploid with low SPF) and Auer I had a distant metastasis rate of 3/60 (5%), as compared to 62/154 (40%) for all other combinations of the Flow and Auer classifications taken together. Thus, the only findings of prognostic importance were that some samples were Flow I but not Auer I, or vice versa. These two groups represent 17 (7.7%) and 14 (6.3%), respectively, of the total number of samples, and had frequencies of distant metastasis similar to those of the other high-risk groups, namely, 7/17 and 5/14, respectively. In a multivariate analysis, flow cytometric S-phase value was a stronger prognostic factor than either the Flow and Auer classification. We conclude that when routine FCM DNA analysis is used, diploid or near-diploid samples with a low S-phase value should be reanalyzed with ICM.
DNA倍体的测量可以通过图像细胞术（ICM）或流式细胞术（FCM）进行；这两种方法在原发性乳腺癌中都能提供独立的预后信息。本研究的目的是比较这两种方法，并将结果与预后（中位随访42个月）相关联。76%的样本（168/222）在倍体状态（二倍体、四倍体、非整倍体）上达成一致。当也考虑到FCM分析中的S期细胞分数（SPF）时，得到了四组不同的样本（流式I-IV），它们被认为与从图像细胞术获得的DNA直方图的奥尔分类（奥尔I-IV）相对应。现在两种技术之间的完全一致性为70%（155/222）。分类为流式I（低SPF的二倍体或近二倍体）和奥尔I的样本远处转移率为3/60（5%），而流式和奥尔分类的所有其他组合加起来为62/154（40%）。因此，唯一具有预后重要性的发现是一些样本是流式I但不是奥尔I，或者反之亦然。这两组分别占样本总数的17（7.7%）和14（6.3%），远处转移频率与其他高危组相似，分别为7/17和5/14。在多变量分析中，流式细胞术的S期值比流式和奥尔分类更具预后因素。我们得出结论，当使用常规FCM DNA分析时，S期值低的二倍体或近二倍体样本应用ICM重新分析。
