Beerman H, Bonsing B A, van de Vijver M J, Hermans J, Kluin P M, Caspers R J, van de Velde C J, Cornelisse C J
Department of Pathology, Faculty of Medicine, Leiden University Hospital, University of Leiden, The Netherlands.
Br J Cancer. 1991 Jul;64(1):139-43. doi: 10.1038/bjc.1991.257.
The value of DNA-flow cytometry and clinico-pathological prognostic factors for the prediction of local recurrences after breast-conserving therapy (BCT) were evaluated in a retrospective study. Thirty-one patients with a local recurrence were compared with 31 matched patients without a local recurrence. Morphology and DNA-indices of the local recurrences and their corresponding primary tumours were compared. Ductal carcinoma in situ was present significantly more often in the group with a primary recurring tumour, than in the matched group (P less than 0.001), and the same holds for lobular carcinoma (n = 5). Half of the tumours that recurred had macroscopically positive surgical margins compared to about one-fourth of the matched group. Fifty-six per cent of the DNA-aneuploid stemlines in cases with local recurrence were present in the corresponding primary tumour as well (confidence limits 45%-75%), an indication that the majority of local recurrences are true recurrences and not independently developed tumours. The lack of similarity of DNA stemlines between some primary DNA-aneuploid tumours and their local recurrences indicates that these tumours had developed independently. The percentage of DNA-aneuploid cases in the group with local recurrence (89%) did not differ significantly from that in the matched group (70%). However, the findings suggest a selective recurrence of DNA-diploid stemlines. This might indicate increased resistance of DNA-diploid tumour cells to radiotherapy as compared with the resistance level in DNA-aneuploid cells.
在一项回顾性研究中，对DNA流式细胞术的价值以及临床病理预后因素在保乳治疗（BCT）后局部复发预测中的作用进行了评估。将31例局部复发患者与31例配对的无局部复发患者进行比较。比较了局部复发灶及其相应原发肿瘤的形态学和DNA指数。原发复发性肿瘤组原位导管癌的出现频率显著高于配对组（P小于0.001），小叶癌（n = 5）情况相同。复发的肿瘤中有一半手术切缘肉眼可见阳性，而配对组约为四分之一。局部复发病例中56%的DNA非整倍体干细胞系也存在于相应的原发肿瘤中（置信区间45%-75%），这表明大多数局部复发是真正的复发，而非独立发生的肿瘤。一些原发性DNA非整倍体肿瘤与其局部复发灶之间DNA干细胞系缺乏相似性，表明这些肿瘤是独立发生的。局部复发组中DNA非整倍体病例的百分比（89%）与配对组（70%）无显著差异。然而，研究结果提示DNA二倍体干细胞系存在选择性复发。这可能表明与DNA非整倍体细胞的耐药水平相比，DNA二倍体肿瘤细胞对放疗的耐药性增加。
