Toyota K, Nagamori S, Kashiwagi A, Nonomura K, Koyanagi T
Department of Urology, Hokkaido University School of Medicine, Sapporo, Japan.
Nihon Hinyokika Gakkai Zasshi. 1995 Sep;86(9):1435-9. doi: 10.5980/jpnjurol1989.86.1435.
This study was designed to evaluate DNA ploidy patterns and metastatic patterns between primary tumors and metastatic lymph nodes in bladder tumor patients with lymph node metastases.
Flow cytometry (FCM) was used to study the DNA ploidy. The DNA ploidy patterns in 16 lymph node metastases in relation to the degree of ploidy in the primary bladder tumor were evaluated in 63 patients who underwent total cystectomy.
The primary tumor that had metastasized was G3 tumor in grade and over pT2 in stage in many cases. Thirty-nine diploid tumors had given raise to lymph node metastases in only 5 cases (13%), whereas 11 cases (46%) of aneuploid tumors had metastasized (p < 0.01). With regard to ploidy patterns between primary tumors and the corresponding lymph node metastases, four patterns were noted, namely D-->D (5 cases), D + A-->D (4), A-->A (5) and A-->D (2) (D: DNA diploid, A: DNA aneuploid). The DNA index between the primary tumors and the corresponding lymph node metastases was the same in all but 2 cases (14/16.88%). In cases with lymph node metastases, the prognosis was very poor whether or not the DNA ploidy of the primary tumors or the metastatic tumors was DNA aneuploid.
These data suggest that a malignant cell on the primary tumor metastasized to the lymph node in many cases.
本研究旨在评估伴有淋巴结转移的膀胱肿瘤患者原发肿瘤与转移淋巴结之间的DNA倍体模式及转移模式。
采用流式细胞术(FCM)研究DNA倍体。对63例行全膀胱切除术患者的16个转移淋巴结的DNA倍体模式与原发性膀胱肿瘤的倍体程度进行评估。
发生转移的原发肿瘤多为G3级且分期超过pT2期。39个二倍体肿瘤仅5例(13%)发生淋巴结转移,而异倍体肿瘤有11例(46%)发生转移(p<0.01)。关于原发肿瘤与相应转移淋巴结之间的倍体模式,观察到四种模式,即D→D(5例)、D+A→D(4例)A→A(5例)和A→D(2例)(D:DNA二倍体,A:DNA异倍体)。除2例(14/16,88%)外,原发肿瘤与相应转移淋巴结之间的DNA指数相同。在有淋巴结转移的病例中,无论原发肿瘤或转移肿瘤的DNA倍体是否为异倍体,预后都很差。
这些数据表明,在许多情况下,原发肿瘤上的恶性细胞转移至淋巴结。