Nakai H, Tachibana M, Baba S, Deguchi N, Jitsukawa S, Hata M, Tazaki H
Nihon Hinyokika Gakkai Zasshi. 1989 Jan;80(1):11-6. doi: 10.5980/jpnjurol1989.80.11.
Flow cytometric DNA analysis (FCM) of adrenal tumors was studied to evaluate whether FCM will be a useful examination for differentiating between benign and malignant adrenal tumors. 10 specimens of surgically resected (for renal cell carcinoma confined within the middle or lower pole) normal adrenal glands and 20 specimens of surgically resected adrenal tumors were submitted for the study. Hyperplastic adrenal cortex as well as normal adrenal gland showed normal diploid pattern. On the other hand, some of the cortical adenomas showed tetraploid patterns, which has been known to be an index of malignancy in most of the flow cytometric intervention to other solid tumors. Conn adenomas were especially apt to show this tendency, in which as much as 86% showed tetraploid pattern. Proliferation Index (PI) (ratio of S + G2 +M cells for the whole population of analyzed cells) were as much as 9.45 +/- 6.97% in normal adrenal cells, whereas it was much higher in cortical adenomas (17.75 +/- 8.53%). As a matter of fact, PI of hyperplastic adrenal cortex was within the same range as that of the normal adrenal glands. In pheochromocytomas, aneuploid pattern, which has been believed to be a definite index of malignancy, was shown in 60% of the cases, tetraploid pattern in 20%, and normal diploid pattern in only 20%. As a matter of fact, a case of non functioning cortical adenocarcinoma and a case of malignant pheochromocytoma were judged to show typical aneuploid pattern. Thus, the application of the flow cytometric diagnosis for adrenal tumors was supposed to require some refinement in understanding the significance of aneuploidy or tetraploidy.
对肾上腺肿瘤进行了流式细胞术DNA分析（FCM），以评估FCM是否会成为鉴别肾上腺良恶性肿瘤的有用检查方法。本研究提交了10例手术切除的（用于局限于中或下极的肾细胞癌）正常肾上腺标本和20例手术切除的肾上腺肿瘤标本。增生的肾上腺皮质以及正常肾上腺均显示正常二倍体模式。另一方面，一些皮质腺瘤显示四倍体模式，在大多数对其他实体瘤的流式细胞术干预中，四倍体模式被认为是恶性肿瘤的指标。Conn腺瘤尤其容易出现这种趋势，其中高达86%显示四倍体模式。增殖指数（PI）（S + G2 +M期细胞占分析细胞总数的比例）在正常肾上腺细胞中高达9.45 +/- 6.97%，而在皮质腺瘤中则高得多（17.75 +/- 8.53%）。事实上，增生的肾上腺皮质的PI与正常肾上腺的PI在同一范围内。在嗜铬细胞瘤中，60%的病例显示非整倍体模式，这被认为是恶性肿瘤的确切指标，20%显示四倍体模式，仅20%显示正常二倍体模式。事实上，一例无功能皮质腺癌和一例恶性嗜铬细胞瘤被判定显示典型的非整倍体模式。因此，在理解非整倍体或四倍体的意义方面，流式细胞术诊断在肾上腺肿瘤中的应用可能需要进一步完善。
