Oud P S, Pahlplatz M M, Beck J L, Wiersma-Van Tilburg A, Wagenaar S J, Vooijs G P
Institute for Pathological Anatomy, University of Nijmegen, The Netherlands.
Cancer. 1989 Sep 15;64(6):1304-9. doi: 10.1002/1097-0142(19890915)64:6<1304::aid-cncr2820640623>3.0.co;2-k.
Both image and flow DNA cytometry were performed in isolated nuclei from paraffin-embedded tumor tissue of patients with small cell carcinoma of the lung (SCCL). In 14 patients tissue was obtained by surgery from the primary tumor. From 14 patients tissue was taken by autopsy. From two patients tissue obtained by both surgery and later autopsy were available. From the autopsy patients tissue was taken only from the primary tumor (n = 6), from a metastasis (n = 1) and from the primary tumor and distant metastases (n = 7). Twelve of the tumors obtained by surgery were diploid, and two multiploid (two stem lines present). This was found both with image and flow cytometry. The group of patients could clearly be subdivided in short survivors (less than 9 months, n = 6) and long survivors (greater than 16 months, n = 8); since in both groups one multiploid and the remainder diploid cases were present, ploidy did not seem to be a good prognosticator for survival. In most (n = 26) of the tissues measured from the autopsy patients, again, a good correlation between image and flow DNA cytometry was obtained, the histograms being either (near) diploid or multiploid. In six cases, however, flow cytometry showed multiploidy whereas image showed aneuploidy (one single peak clearly deviating from diploidy). This discrepancy is caused because normal diploid (nonneoplastic) cells in the preparations could not be discarded from the flow cytometry measurements. Using the image cytometry data of the primary tumors, five diploid, three aneuploid, and four multiploid tumors were found. In five of the seven patients of whom tissue was obtained from the primary tumor and multiple metastases, differences between the histograms were found, mostly showing two malignant cell populations in one tissue and only one of them in another. Of one of the two patients of whom tissue was obtained by surgery and later autopsy, a change in histogram pattern was observed. It is concluded that although there is a high similarity between image and flow DNA cytometry, for an optimal interpretation of the histogram pattern, image measurements are more reliable. Ploidy determination does not seem to be of use in prediction of survival, and care should be taken in interpreting DNA histograms of metastases in SCCL patients because of the variability in histogram pattern.
对肺小细胞癌（SCCL）患者石蜡包埋肿瘤组织分离的细胞核进行了图像和流式DNA细胞术检测。14例患者的组织通过手术取自原发性肿瘤，14例患者的组织通过尸检获取，另有2例患者同时有手术和尸检获取的组织。对于尸检患者，组织仅取自原发性肿瘤（n = 6）、转移灶（n = 1）以及原发性肿瘤和远处转移灶（n = 7）。手术获取的肿瘤中有12个为二倍体，2个为多倍体（存在两条干细胞系），图像和流式细胞术检测结果均如此。该组患者可明显分为短期存活者（少于9个月，n = 6）和长期存活者（大于16个月，n = 8）；由于两组中均有一个多倍体病例和其余二倍体病例，倍性似乎并非生存的良好预后指标。在大多数（n = 26）尸检患者的组织检测中，图像和流式DNA细胞术再次呈现良好相关性，直方图为（接近）二倍体或多倍体。然而，有6例流式细胞术显示为多倍体，而图像显示为非整倍体（一个单峰明显偏离二倍体）。这种差异是因为在流式细胞术测量中无法去除制剂中的正常二倍体（非肿瘤性）细胞。利用原发性肿瘤的图像细胞术数据，发现了5个二倍体肿瘤、3个非整倍体肿瘤和4个多倍体肿瘤。在7例组织取自原发性肿瘤和多个转移灶的患者中，有5例发现直方图存在差异，大多表现为一个组织中有两个恶性细胞群体，而在另一个组织中只有其中之一。在通过手术和后来尸检获取组织的2例患者中，有1例观察到直方图模式发生了变化。结论是，尽管图像和流式DNA细胞术之间有高度相似性，但为了最佳解读直方图模式，图像测量更可靠。倍性测定似乎对生存预测无用，并且由于SCCL患者转移灶DNA直方图模式的变异性，在解读时应谨慎。
