细胞DNA含量对分化型甲状腺癌生存的影响。

Influence of cellular DNA content on survival in differentiated thyroid cancer.

作者信息

Joensuu H, Klemi P, Eerola E, Tuominen J

出版信息

Cancer. 1986 Dec 1;58(11):2462-7. doi: 10.1002/1097-0142(19861201)58:11<2462::aid-cncr2820581119>3.0.co;2-e.

DOI:10.1002/1097-0142(19861201)58:11<2462::aid-cncr2820581119>3.0.co;2-e

Abstract

Cellular DNA content was measured using a novel flow cytometric method to analyze paraffin-embedded tissue blocks from 125 patients with differentiated thyroid cancer. DNA aneuploidy was found in 20 (24%) of the 82 papillary, 20 (56%) of the 36 follicular, and in four (57%) of the seven medullary carcinomas. Aneuploidy was found to be more common in the elderly (P less than 0.002), in moderately and poorly differentiated carcinomas (P less than 0.004), and in tumors infiltrating beyond the thyroid capsule (P less than 0.03). Patients with an aneuploid tumor had less favorable cumulative survival (P less than 0.0001) than patients with diploid cancer. However, in papillary and follicular carcinomas, multivariate analysis using stepwise Cox model showed age at diagnosis, follicular type, and tumor invasion beyond the thyroid capsule to be more important independent prognostic factors. Increasing probability of DNA aneuploidy with increasing age explains partially why prognosis of differentiated thyroid carcinoma is poor in older patients.

摘要

采用一种新型流式细胞术方法测定了125例分化型甲状腺癌患者石蜡包埋组织块的细胞DNA含量。在82例乳头状癌中，有20例（24%）存在DNA非整倍体；在36例滤泡状癌中，有20例（56%）存在DNA非整倍体；在7例髓样癌中，有4例（57%）存在DNA非整倍体。研究发现，非整倍体在老年患者中更为常见（P<0.002），在中低分化癌中更为常见（P<0.004），在浸润超出甲状腺包膜的肿瘤中更为常见（P<0.03）。与二倍体癌患者相比，非整倍体肿瘤患者的累积生存率更低（P<0.0001）。然而，在乳头状癌和滤泡状癌中，使用逐步Cox模型进行的多因素分析显示，诊断时的年龄、滤泡类型以及肿瘤浸润超出甲状腺包膜是更重要的独立预后因素。随着年龄增长，DNA非整倍体的概率增加，这部分解释了为什么老年分化型甲状腺癌患者的预后较差。