Frankfurt O S, Chin J L, Englander L S, Greco W R, Pontes J E, Rustum Y M
Cancer Res. 1985 Mar;45(3):1418-23.
DNA ploidy was evaluated by flow cytometry for 45 human prostate carcinomas (34 prostatectomy specimens and 11 biopsies). Twenty tumors (44.4%) contained a distinct aneuploid stem line. All 11 tumors confined to the prostate gland (pathological Stage B) were diploid. The frequency of aneuploidy increased with advancing stage, and most tumors with distant metastases were aneuploid. The degree of glandular differentiation was characterized by the Gleason score. One-third of tumors with a Gleason score of 5 to 6 were aneuploid, whereas over 70% of poorly differentiated tumors with a Gleason score of 9 to 10 were aneuploid. Among diploid tumors, 45.5% were localized carcinomas (Stage B), 36.4% were characterized by invasion outside the prostate (Stage C), and 18.2% formed pelvic nodal or distant metastases (Stages D1 and D2). In nearly two-thirds of patients with aneuploid tumors, pelvic nodal or distant metastases were found. When tumors were classified according to both DNA ploidy and degree of glandular differentiation, then subgroups of tumors with the highest and lowest degree of malignant potential became apparent. Only 7.1% of diploid tumors with a Gleason score of 5 to 6 formed metastases, but 80% of aneuploid tumors with a higher Gleason score (7 to 10) formed metastases. Diploid tumors with higher Gleason scores and aneuploid tumors with lower Gleason scores had intermediate frequencies of metastases. The presence of an aneuploid stem line in prostate carcinomas indicated that the tumor had spread outside the prostate gland or had metastasized. DNA ploidy may be an important prognostic factor for human prostate cancer. DNA ploidy and the degree of glandular differentiation considered together may improve prognostic evaluation of prostate carcinomas.
采用流式细胞术对45例人类前列腺癌（34例前列腺切除术标本和11例活检标本）进行DNA倍体评估。20例肿瘤（44.4%）含有明显的非整倍体干细胞系。所有局限于前列腺腺体的11例肿瘤（病理分期B期）均为二倍体。非整倍体的频率随分期进展而增加，大多数伴有远处转移的肿瘤为非整倍体。腺分化程度以Gleason评分来表征。Gleason评分为5至6分的肿瘤中有三分之一为非整倍体，而Gleason评分为9至10分的低分化肿瘤中超过70%为非整倍体。在二倍体肿瘤中，45.5%为局限性癌（B期），36.4%的特征为侵犯前列腺外（C期），18.2%形成盆腔淋巴结或远处转移（D1期和D2期）。在近三分之二的非整倍体肿瘤患者中发现了盆腔淋巴结或远处转移。当根据DNA倍体和腺分化程度对肿瘤进行分类时，具有最高和最低恶性潜能程度的肿瘤亚组变得明显。Gleason评分为5至6分的二倍体肿瘤中只有7.1%发生转移，但Gleason评分较高（7至10分）的非整倍体肿瘤中有80%发生转移。Gleason评分较高的二倍体肿瘤和Gleason评分较低的非整倍体肿瘤转移频率处于中间水平。前列腺癌中存在非整倍体干细胞系表明肿瘤已扩散至前列腺外或已发生转移。DNA倍体可能是人类前列腺癌的一个重要预后因素。综合考虑DNA倍体和腺分化程度可能会改善前列腺癌的预后评估。
