Hemmer J, Kreidler J, Vanheerden W, Raubenheimer E, Schon E
UNIV ULM,DEPT ORAL & MAXILLOFACIAL SURG,W-7900 ULM,GERMANY. MED UNIV S AFRICA,DEPT ORAL PATHOL,CAPE TOWN,SOUTH AFRICA.
Int J Oncol. 1995 Jun;6(6):1237-42. doi: 10.3892/ijo.6.6.1237.
This prospective DNA flow cytometric study on 386 primary squamous cell carcinomas of the oral cavity showed that only 18% of the patients with diploid primary tumors had lymph node metastasis on admission compared to 52% of those with aneuploid carcinomas. The aneuploid group without evidence of lymph node involvement at the time of primary tumor treatment carried a 3-fold increased risk for developing late metastasis (23%) compared with the diploid group (8%). The clinical manifestation of occult metastasis in patients with diploid carcinomas was delayed by about two years compared to the aneuploid group. These ploidy-specific differences of the metastatic behaviour held true even if stratified with respect to tumor stage, histological grade and tumor localization. These results provide substantial evidence that cells with gross DNA content aberrations have a significantly higher probability of successfully producing a metastatic colony than flow cytometrically diploid tumor cells. An excellent 5-year survival rate of 90% in the diploid NO group in contrast to 52% in aneuploid NO cases and an even worse survival rate of 21% in patients with lymph node involvement at presentation underline the clinical importance of these findings.
这项针对386例口腔原发性鳞状细胞癌的前瞻性DNA流式细胞术研究表明，二倍体原发性肿瘤患者中只有18%在入院时发生淋巴结转移，而三倍体癌患者这一比例为52%。在原发性肿瘤治疗时无淋巴结受累证据的三倍体组发生晚期转移（23%）的风险是二倍体组（8%）的3倍。与三倍体组相比，二倍体癌患者隐匿性转移的临床表现延迟约两年。即使根据肿瘤分期、组织学分级和肿瘤定位进行分层，这些转移行为的倍体特异性差异依然存在。这些结果提供了充分的证据，表明DNA含量明显异常的细胞比流式细胞术检测为二倍体的肿瘤细胞成功形成转移瘤的概率显著更高。二倍体无淋巴结转移组出色的5年生存率为90%，而三倍体无淋巴结转移病例为52%，就诊时有淋巴结受累的患者生存率更差，为21%强调了这些发现的临床重要性。
