Nishi T, Okajima K, Taguchi T, Mizutani H, Sogabe T, Uragami I, Sekimoto T
Department of Surgery, Osaka Medical College, Takatsuki, Japan.
Nihon Geka Gakkai Zasshi. 1988 Apr;89(4):576-81.
The relationship between nuclear DNA content measured by cytofluorometry and the prognostic factors, especially the histological lymph node metastasis was investigated in patients with breast cancer. Nuclear DNA content was measured in 82 cases to evaluate its clinical significance concerning the malignancy grading. Histograms of DNA content were classified into two basic ploidy patterns based on presence or absence of a prominent peak at the 2c (diploid) region. D type (diploid type) which had a prominent peak at the 2c region resembled the histogram pattern of normal cells more closely than N type (non-diploid type). The rate of lymph node metastasis of N type (57.4%) was significantly higher than that of D type (28.6%) (p less than 0.05). The rate of lymph node metastasis of N type was higher than D type regardless of the tumor size or histological types. The five year cumulative survival rate of D type (91.7%) was significantly higher than that of N type (68.2%) (p less than 0.05). Despite the lymph node metastasis, the survival rate of D type was higher than that of N type. From a view point of the relationship between nuclear DNA content and lymph node metastasis, breast cancers of D type might be much safer indications for modified radical mastectomy. From this study, it was suggested that the measurement of nuclear DNA content of the breast cancer would bring the important informations about the malignancy grading and decision of the operative procedure.
我们对乳腺癌患者通过细胞荧光测定法测量的核DNA含量与预后因素,尤其是组织学上的淋巴结转移之间的关系进行了研究。对82例患者测量了核DNA含量,以评估其在恶性肿瘤分级方面的临床意义。根据在2c(二倍体)区域是否存在明显峰值,将DNA含量直方图分为两种基本的倍体模式。在2c区域有明显峰值的D型(二倍体型)比N型(非二倍体型)更类似于正常细胞的直方图模式。N型的淋巴结转移率(57.4%)显著高于D型(28.6%)(p小于0.05)。无论肿瘤大小或组织学类型如何,N型的淋巴结转移率均高于D型。D型的五年累积生存率(91.7%)显著高于N型(68.2%)(p小于0.05)。尽管有淋巴结转移,D型的生存率仍高于N型。从核DNA含量与淋巴结转移的关系来看,D型乳腺癌可能是改良根治性乳房切除术更安全的适应症。从这项研究表明,测量乳腺癌的核DNA含量将为恶性肿瘤分级和手术方案的决策带来重要信息。