Joensuu H, Klemi P J
Department of Radiotherapy, University Central Hospital of Turku, Finland.
Am J Pathol. 1988 Jul;132(1):145-51.
The nuclear DNA content of 44 pituitary, 49 thyroid, 54 parathyroid, and 17 adrenal adenomas was analyzed from paraffin-embedded tissue with flow cytometry. Interpretable histograms of good quality (CV less than 7%, mean CV, 4%) were obtained in 96% of the cases. Unequivocal evidence of DNA aneuploidy was found in 29% of pituitary, 25% of thyroid, 35% of parathyroid, and in 53% of adrenal adenomas. Excluding the multiploid (N = 2) and tetraploid adenomas (N = 5), the DNA indices of aneuploid adenomas were generally small (mean, 1.34). Patients with a diploid thyroid or parathyroid adenoma had a lower mean age at diagnosis than patients with a nondiploid adenoma. None of the adenomas gave rise to metastases after conservative surgery. It is concluded that DNA aneuploidy is common in endocrine adenomas and that the presence of DNA aneuploidy is not incompatible with a benign histologic diagnosis. The usefulness of DNA aneuploidy as a conclusive sign of malignancy in clinical practice is questioned.
采用流式细胞术对44例垂体腺瘤、49例甲状腺腺瘤、54例甲状旁腺腺瘤和17例肾上腺腺瘤石蜡包埋组织的核DNA含量进行了分析。96%的病例获得了质量良好(变异系数小于7%,平均变异系数为4%)的可解释直方图。在29%的垂体腺瘤、25%的甲状腺腺瘤、35%的甲状旁腺腺瘤和53%的肾上腺腺瘤中发现了明确的DNA非整倍体证据。排除多倍体(N = 2)和四倍体腺瘤(N = 5)后,非整倍体腺瘤的DNA指数通常较小(平均为1.34)。二倍体甲状腺或甲状旁腺腺瘤患者的诊断时平均年龄低于非二倍体腺瘤患者。保守手术后,无一例腺瘤发生转移。结论是,DNA非整倍体在内分泌腺瘤中很常见,并且DNA非整倍体的存在与良性组织学诊断并不矛盾。对DNA非整倍体作为临床实践中恶性肿瘤的确切标志的实用性提出了质疑。