Armitage N C, Ballantyne K C, Evans D F, Clarke P, Sheffield J, Hardcastle J D
Department of Surgery, University Hospital, Nottingham, UK.
Br J Cancer. 1990 Nov;62(5):852-6. doi: 10.1038/bjc.1990.393.
We have investigated the influence of tumour cell DNA content (ploidy) on survival of 416 patients undergoing excisional surgery for colorectal cancer. Two hundred and eleven (51%) tumours had an abnormal DNA content (aneuploid or tetraploid). There was no correlation between ploidy status, sex, age and pathological stage, histological grade, tumour site, local tumour extension or assessment of curability. Patients with tumours with an abnormal DNA content had a poorer survival 68/211 (32%) than patients with near normal (diploid) DNA content 88/205 (43%) (test statistic 5.0, P = 0.02). The patient subgroups in which DNA content exerted an influence on survival were: stage B tumours (P = 0.0058), moderately differentiated tumours (P = 0.004), rectal tumours (P = 0.02), and mobile tumours (P = 0.02). Multivariant analysis showed that pathological stage, local tumour extension and DNA ploidy were all independent prognostic indicators whereas histological grade, tumour site and assessment of 'curability' were not. The influence of pathological stage, however, was much greater than that of local tumor extension or DNA ploidy. Tumour cell DNA content together with pathological stage and local tumour extension may be used in a prognostic index and may be important in planning adjuvant therapy.
我们研究了肿瘤细胞DNA含量（倍体性）对416例行结直肠癌切除手术患者生存情况的影响。211例（51%）肿瘤的DNA含量异常（非整倍体或四倍体）。倍体状态与性别、年龄、病理分期、组织学分级、肿瘤部位、局部肿瘤浸润或可治愈性评估之间无相关性。DNA含量异常的肿瘤患者生存率[68/211（32%）]低于DNA含量接近正常（二倍体）的患者[88/205（43%）]（检验统计量5.0，P = 0.02）。DNA含量对生存有影响的患者亚组为：B期肿瘤（P = 0.0058）、中度分化肿瘤（P = 0.004）、直肠肿瘤（P = 0.02）和可移动肿瘤（P = 0.02）。多变量分析显示，病理分期、局部肿瘤浸润和DNA倍体均为独立的预后指标，而组织学分级、肿瘤部位和“可治愈性”评估则不是。然而，病理分期的影响远大于局部肿瘤浸润或DNA倍体。肿瘤细胞DNA含量连同病理分期和局部肿瘤浸润可用于预后指数，在辅助治疗方案规划中可能很重要。
