Cusick E L, MacIntosh C A, Krukowski Z H, Ewen S W, Matheson N A
Department of Surgery, University of Aberdeen, UK.
Br J Surg. 1990 Aug;77(8):913-6. doi: 10.1002/bjs.1800770824.
The prognostic accuracy of flow cytometric and static densitometric DNA analysis was compared in 31 patients who had undergone surgery for papillary thyroid carcinoma between 1959 and 1978 (median follow-up 18 years). There were five deaths from papillary thyroid carcinoma. Three of six patients with DNA aneuploid tumours on flow cytometry died (P greater than 0.05, Fisher's exact test) compared with four of eight patients whose tumours were found to be aneuploid by static densitometry (P less than 0.02). When quantitative analysis was applied to the static densitometry data, all five patients who died from papillary carcinoma were distinguished, with no false positives (P less than 0.002). The prognostic accuracy of flow cytometric DNA analysis is less than that of static densitometry in which morphological selection of malignant cells permits quantitative measurements. DNA analysis may add refinement to existing scoring systems in predicting the risk of death from papillary thyroid carcinoma. Such information could provide the basis for controlled prospective evaluation of bilateral resection as opposed to lobectomy in defined high risk patients. At present there is insufficient evidence upon which aneuploidy should be used as a determinant of the extent of operation for papillary thyroid carcinoma.
对1959年至1978年间接受乳头状甲状腺癌手术的31例患者（中位随访时间18年），比较了流式细胞术和静态密度测定法DNA分析的预后准确性。有5例死于乳头状甲状腺癌。流式细胞术检测为DNA非整倍体肿瘤的6例患者中有3例死亡（P>0.05，Fisher精确检验），而静态密度测定法检测肿瘤为非整倍体的8例患者中有4例死亡（P<0.02）。当对静态密度测定数据进行定量分析时，所有5例死于乳头状癌的患者均被区分出来，且无假阳性（P<0.002）。在恶性细胞形态学选择允许进行定量测量的静态密度测定法中，流式细胞术DNA分析的预后准确性低于静态密度测定法。DNA分析可能会使现有的评分系统在预测乳头状甲状腺癌死亡风险方面更加完善。这些信息可为在特定高危患者中对双侧切除术与叶切除术进行对照前瞻性评估提供依据。目前，没有足够的证据表明非整倍体应作为乳头状甲状腺癌手术范围的决定因素。
