Armitage N C, Ballantyne K C, Sheffield J P, Clarke P, Evans D F, Hardcastle J D
Department of Surgery, University Hospital, Nottingham, United Kingdom.
Cancer. 1991 May 15;67(10):2599-604. doi: 10.1002/1097-0142(19910515)67:10<2599::aid-cncr2820671033>3.0.co;2-6.
Tumor cell DNA (ploidy) content was measured prospectively in samples from 320 patients resected for colorectal cancer with a minimum follow-up time of 2 years. All patients were followed and those with recurrence were investigated carefully. There was no correlation between tumors with an abnormal cellular DNA content (aneuploid or tetraploid) and patient age, sex, tumor site, pathologic stage, or histologic grade. In 236 patients who underwent potentially curative operations, 75 (32%) had local and/or distant recurrence. The recurrence rate was significantly higher (test statistic, 4.3; P = 0.04) for those patients with aneuploid tumors (52 of 142, 37%) compared with those with diploid tumors (23 of 94, 24%). The subgroups of patients where ploidy exerted an effect were in patients with Stage B tumors or mobile tumors and in patients over 65 years of age. Further analysis showed that there was a twofold increase in local recurrence and a threefold increase in distant recurrence in patients with aneuploid tumors, but no excess of patients who had both local and distant recurrence. Measurement of DNA ploidy can identify a group of patients undergoing curative surgery for colorectal cancer at high risk for recurrence. In combination with clinicopathologic factors, DNA ploidy may be useful in analyzing the results of trials and in planning adjuvant therapy.
前瞻性地测量了320例接受结直肠癌切除术患者的样本中的肿瘤细胞DNA（倍体）含量，这些患者的最短随访时间为2年。对所有患者进行随访，并对复发患者进行仔细调查。细胞DNA含量异常（非整倍体或四倍体）的肿瘤与患者年龄、性别、肿瘤部位、病理分期或组织学分级之间无相关性。在236例接受了潜在根治性手术的患者中，75例（32%）出现了局部和/或远处复发。与二倍体肿瘤患者（94例中的23例，24%）相比，非整倍体肿瘤患者（142例中的52例，37%）的复发率显著更高（检验统计量为4.3；P = 0.04）。倍体发挥作用的患者亚组为B期肿瘤或可移动肿瘤患者以及65岁以上患者。进一步分析表明，非整倍体肿瘤患者的局部复发增加了两倍，远处复发增加了三倍，但同时出现局部和远处复发的患者并无增多。测量DNA倍体可以识别一组接受结直肠癌根治性手术但复发风险高的患者。结合临床病理因素，DNA倍体可能有助于分析试验结果和规划辅助治疗。
