Giaretti W, Danova M, Geido E, Mazzini G, Sciallero S, Aste H, Scivetti P, Riccardi A, Marsano B, Merlo F
Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
Cancer. 1991 Apr 1;67(7):1921-7. doi: 10.1002/1097-0142(19910401)67:7<1921::aid-cncr2820670717>3.0.co;2-x.
The authors investigated the relationship between flow cytometric DNA index (DI, defined as the ratio of the DNA content of malignant cells to that of normal cells) and other prognostic factors (grade and stage, anatomical site, age and sex) with the survival of 115 patients with colorectal cancer. Multiple biopsy specimens from 62 patients were taken during colonoscopy before surgery. Additional samples from 53 patients were obtained from paraffin-embedded material. All patients were treated with surgery only. Fresh-frozen material gave higher incidence of DNA aneuploidy than paraffin-embedded material (79% versus 41%). The patients with DNA diploid tumors (DI = 1) had a better overall survival than those with DNA aneuploid tumors (DI = 1). Among DNA aneuploid tumors, those with DI greater than 1.2 (excluding DI = 2) were worse than those with DI = 1.2 (excluding DI = 1) and DI = 2. Cox's regression analysis showed that pathologic stage was more important for prognosis than DNA index, whereas age, sex, histologic grade, and anatomic site were removed from the analysis as not relevant for prognosis. Relative risk of death (RR), in reference to patients with DI = 1 and Stages A + B (RR = 1), were RR = 1.8 for patients with carcinomas with Stage C. RR = 2.7 for patients with carcinomas with DNA near-diploid and DNA tetraploid tumors. RR = 3.5 for those with DI greater than 1.2 (excluding DI = 2), and RR = 8.0 for those with Stage D. These data indicate that flow cytometrically evaluated DI values have a relevant independent power for predicting the clinical outcome of colorectal cancer patients.
作者研究了流式细胞术DNA指数（DI，定义为恶性细胞与正常细胞DNA含量之比）与其他预后因素（分级和分期、解剖部位、年龄和性别）与115例结直肠癌患者生存率之间的关系。62例患者在术前结肠镜检查时采集了多个活检标本。另外53例患者的样本取自石蜡包埋材料。所有患者均仅接受手术治疗。新鲜冷冻材料的DNA非整倍体发生率高于石蜡包埋材料（79%对41%）。DNA二倍体肿瘤（DI = 1）患者的总生存率高于DNA非整倍体肿瘤（DI = 1）患者。在DNA非整倍体肿瘤中，DI大于1.2（不包括DI = 2）的患者比DI = 1.2（不包括DI = 1）和DI = 2的患者预后更差。Cox回归分析表明，病理分期对预后比DNA指数更重要，而年龄、性别、组织学分级和解剖部位因与预后无关而被排除在分析之外。相对于DI = 1且处于A + B期（RR = 1）的患者，C期癌患者的死亡相对风险（RR）为1.8。DNA近二倍体和DNA四倍体肿瘤癌患者的RR为2.7。DI大于1.2（不包括DI = 2）的患者RR为3.5，D期患者的RR为8.0。这些数据表明，通过流式细胞术评估的DI值对预测结直肠癌患者的临床结局具有相关的独立作用。
