Lee S E, Kim Y K
Department of Urology, Seoul National University College of Medicine, Korea.
Int J Urol. 1994 Sep;1(3):232-6. doi: 10.1111/j.1442-2042.1994.tb00041.x.
Flow cytometry was used to evaluate 93 deparaffinized transurethral resection or cystectomy specimens to investigate the predictability of DNA profiles with regard to pelvic lymph node metastasis. The pathological stage and grade were also compared with the status of the pelvic lymph node. The incidence of aneuploidy in the total specimen group was 55 out of 93 (59%). Aneuploidy and pathologic stage were significant risk factors for pelvic lymph node metastasis (p = 0.0091, 0.0008 respectively) but histologic grade was not correlated with pelvic lymph node status (p = 0.7418). Aneuploidy was noted in all of the 11 specimens exhibiting lymph node involvement compared with 44 of the 82 (54%) without lymph node involvement (p = 0.0091). There was no positive pelvic lymph node involvement in patients with diploid tumor compared with 11 of the 55 (20%) patients with aneuploid tumors. In conclusion, the recognition of a DNA aneuploid stemline in a primary transitional cell carcinoma of the bladder is statistically correlated with a greater likelihood of pelvic lymph node metastasis. This suggests that preoperative DNA flow cytometry for primary tumor might be helpful in selecting patients who should be offered additional treatment such as neoadjuvant chemotherapy before definitive treatment or a more conservative approach such as transurethral resection.
采用流式细胞术对93例经尿道前列腺切除术或膀胱切除术石蜡包埋标本进行评估，以研究DNA谱对盆腔淋巴结转移的预测价值。同时将病理分期和分级与盆腔淋巴结状态进行比较。在全部标本组中，非整倍体发生率为93例中的55例（59%）。非整倍体和病理分期是盆腔淋巴结转移的显著危险因素（p值分别为0.0091和0.0008），但组织学分级与盆腔淋巴结状态无关（p = 0.7418）。在所有11例有淋巴结受累的标本中均发现非整倍体，与之相比，82例无淋巴结受累的标本中有44例（54%）存在非整倍体（p = 0.0091）。二倍体肿瘤患者未出现盆腔淋巴结阳性受累，而55例非整倍体肿瘤患者中有11例（20%）出现盆腔淋巴结阳性受累。总之，在原发性膀胱移行细胞癌中识别出DNA非整倍体干系在统计学上与盆腔淋巴结转移的可能性更大相关。这表明对原发性肿瘤进行术前DNA流式细胞术检测可能有助于选择患者，这些患者在确定性治疗前应接受额外治疗，如新辅助化疗，或采取更保守的方法，如经尿道切除术。
