Nativ O, Winkler H Z, Raz Y, Therneau T M, Farrow G M, Myers R P, Zincke H, Lieber M M
Department of Urology, Mayo Clinic, Rochester, MN 55905.
Mayo Clin Proc. 1989 Aug;64(8):911-9. doi: 10.1016/s0025-6196(12)61218-x.
Flow cytometric nuclear DNA ploidy analysis was used to study pathologic stage C prostatic adenocarcinoma (pT3, N0, M0) in 146 patients who underwent radical retropubic prostatectomy and bilateral pelvic lymphadenectomy between 1967 and 1981. Of these tumors, 46% had a DNA diploid pattern, 47% had a DNA tetraploid pattern, and 7% had a DNA aneuploid pattern. Abnormal ploidy patterns were associated more frequently with histologic high-grade tumors than with low-grade tumors. Considered alone, DNA ploidy pattern showed a strong association with subsequent prognosis. The median interval to progression for tumors with DNA tetraploid and DNA aneuploid patterns was 7.8 and 3.5 years, respectively. For the DNA diploid tumors, only 23% progressed within 18 years, the longest follow-up. At 10 years, only 10% of patients with DNA diploid tumors had died of prostatic cancer, in comparison with 28% of the DNA tetraploid and 36% of the DNA aneuploid groups (P less than 0.01). By analysis of a combination of histologic tumor grade and nuclear DNA ploidy pattern, an even stronger association with prognosis was demonstrated. For the 38 patients with histologic low-grade and DNA diploid tumors, progression-free survival was 92% at 10 years, in comparison with 57% for 23 patients with low-grade DNA nondiploid tumors. Patients with high-grade tumor had a poorer prognosis whether the DNA ploidy pattern was diploid or nondiploid. Nuclear DNA ploidy pattern is an important and independent prognostic variable for patients with pathologic stage C prostatic cancer treated by radical prostatectomy.
流式细胞术核DNA倍体分析用于研究1967年至1981年间接受耻骨后根治性前列腺切除术和双侧盆腔淋巴结清扫术的146例C期前列腺腺癌（pT3，N0，M0）患者。在这些肿瘤中，46%呈现DNA二倍体模式，47%呈现DNA四倍体模式，7%呈现DNA非整倍体模式。异常倍体模式在组织学高级别肿瘤中比在低级别肿瘤中更常见。单独考虑时，DNA倍体模式与后续预后密切相关。DNA四倍体和DNA非整倍体模式肿瘤的中位进展间隔分别为7.8年和3.5年。对于DNA二倍体肿瘤，在最长18年的随访中，只有23%在18年内进展。在10年时，DNA二倍体肿瘤患者中只有10%死于前列腺癌，相比之下，DNA四倍体组为28%，DNA非整倍体组为36%（P小于0.01）。通过对组织学肿瘤分级和核DNA倍体模式的综合分析，显示与预后的关联更强。对于38例组织学低级别且DNA二倍体肿瘤患者，10年无进展生存率为92%，相比之下，23例低级别DNA非二倍体肿瘤患者为57%。无论DNA倍体模式是二倍体还是非二倍体，高级别肿瘤患者的预后都较差。核DNA倍体模式是接受根治性前列腺切除术治疗的C期前列腺癌患者的一个重要且独立的预后变量。
