[Evaluation of the malignancy in gallbladder cancer assessed by nuclear DNA contents and mitotic indices--with special reference to the prognosis of the patients with cancer involvement to the subserosal layer].

Nuclear DNA contents and mitotic indices were analyzed in 31 resected specimens of gallbladder cancer to clarify the correlation between malignancy and prognosis of gallbladder cancer. Flow cytometric analysis of nuclear DNA contents showed that 11 specimens (36%) were diploidy and 20 specimens (64%) were aneuploidy. Histologic types were not associated with nuclear DNA contents except the specimens of poorly differentiated adenocarcinoma those were all aneuploidy. Mitotic indices of aneuploid cases were higher than those of diploid cases even on the cases with same histologic type or same depth of invasion. Therefore there was a significant correlation between nuclear DNA contents and mitotic indices. The patients, who had tumor of diploidy or lower mitotic indices, survived significantly longer than those with aneuploidy or higher mitotic indices. In the cases with cancer involvement to subserosal layer of the gallbladder, five year survival rate of diploid cases was 100%, while that of aneuploid cases was 34%. In aneuploid cases, the prognosis of the patients with DNA heterogeneity was good as well as diploid cases. These results suggest that nuclear DNA contents and mitotic indices are considered to be valuable parameters of malignancy of gallbladder cancer and to be prognostic factors.