Joensuu H, Klemi P J
Department of Radiotherapy, University Central Hospital of Turku, Finland.
Am J Clin Pathol. 1988 Jan;89(1):35-40. doi: 10.1093/ajcp/89.1.35.
Nuclear DNA content of 20 cases of primary differentiated thyroid carcinoma, 27 corresponding cervical lymph node metastases, and 2 local recurrent tumors was determined by flow cytometry. Evidence of DNA aneuploidy was found in either the primary tumor or in the corresponding metastases in 10 (63%) of the 16 papillary carcinomas, in all 3 follicular carcinomas, and in the case of medullary carcinoma studied. In all but one case, the aneuploid stemlines found in the regional metastases were also found in the primary or in the recurrent tumor. In four cases diploid metastatic tissue was found to originate from a tumor with DNA aneuploidy, and in three other cases two stemlines of tumor cells with different DNA indices could be shown in the primary tumor, further indicating clonal heterogeneity in differentiated thyroid carcinomas. None of the 11 patients with either diploid or aneuploid primary tumor with a DNA index less than 1.2 evaluated for 4-12 years died from thyroid cancer, whereas 5 of the 7 patients with primary tumor DNA index greater than 1.2 died from thyroid cancer (P less than 0.01).
采用流式细胞术测定了20例原发性分化型甲状腺癌、27例相应的颈部淋巴结转移灶及2例局部复发肿瘤的核DNA含量。在16例乳头状癌中的10例（63%）、所有3例滤泡状癌以及所研究的髓样癌病例中，原发性肿瘤或相应转移灶中均发现了DNA非整倍体证据。除1例之外，在所有病例中，区域转移灶中发现的非整倍体干系也见于原发性肿瘤或复发肿瘤中。在4例病例中，发现二倍体转移组织源自DNA非整倍体肿瘤，在另外3例病例中，原发性肿瘤中可显示出具有不同DNA指数的两种肿瘤细胞干系，这进一步表明分化型甲状腺癌存在克隆异质性。在接受4至12年评估的11例原发性肿瘤为二倍体或DNA指数小于1.2的非整倍体患者中，无1例死于甲状腺癌，而7例原发性肿瘤DNA指数大于1.2的患者中有5例死于甲状腺癌（P<0.01）。
