Albe X, Vassilakos P, Helfer-Guarnori K, Givel J C, de Quay N, Suardet L, Eliason J F, Odartchenko N
Center for Cytology and Cancer Screening, Geneva Tumor Registry, Switzerland.
Cancer. 1990 Sep 15;66(6):1168-75. doi: 10.1002/1097-0142(19900915)66:6<1168::aid-cncr2820660616>3.0.co;2-i.
In a prospective study, the DNA content of Feulgen-stained nuclei obtained from fresh samples of 211 colorectal adenocarcinomas was evaluated by means of image analysis. The DNA histogram classification took into account aneuploidy and S-phase fraction for diploid cases. No significant relationship was found between ploidy and sex, age, preoperative carcinoembryonic antigen (CEA), size of the tumor, histologic differentiation, or Dukes' stage. Aneuploidy was more frequently encountered in distal tumors. Preoperative CEA, histologic differentiation, Dukes' stage, and ploidy were individually associated with overall survival. In Dukes' A, B, and C tumors, patients with normal and elevated CEA had no significant difference in overall survival. A relationship was apparent between disease-free survival and site, histologic differentiation, Dukes' stage, and ploidy. Multivariate overall survival analysis did not reveal independent prognostic significance of ploidy when all Dukes' stages were considered. In contrast, Dukes' stage, differentiation, and ploidy were good indicators of higher risk of colorectal cancer-related death in patients undergoing curative surgery. Dukes' stage and ploidy were also indicators for recurrence. Thus, routine histopathologic characteristics should be used in combination with quantitative cytologic features for the definition of a relevant prognostic index in colorectal cancer.
在一项前瞻性研究中，通过图像分析对从211例结直肠癌新鲜样本中获取的福尔根染色细胞核的DNA含量进行了评估。DNA直方图分类考虑了二倍体病例的非整倍体和S期分数。未发现倍性与性别、年龄、术前癌胚抗原（CEA）、肿瘤大小、组织学分化或Dukes分期之间存在显著关系。非整倍体在远端肿瘤中更常见。术前CEA、组织学分化、Dukes分期和倍性分别与总生存期相关。在Dukes A、B和C期肿瘤中，CEA正常和升高的患者总生存期无显著差异。无病生存期与部位、组织学分化、Dukes分期和倍性之间存在明显关系。当考虑所有Dukes分期时，多变量总生存期分析未显示倍性具有独立的预后意义。相比之下，Dukes分期、分化和倍性是接受根治性手术患者结直肠癌相关死亡风险较高的良好指标。Dukes分期和倍性也是复发指标。因此，在结直肠癌相关预后指标的定义中，常规组织病理学特征应与定量细胞学特征结合使用。
