Hussain M H, Powell I, Zaki N, Maciorowski Z, Sakr W, KuKuruga M, Visscher D, Haas G P, Pontes J E, Ensley J F
Division of Hematology/Oncology, Veterans Administration Medical Center, Allen Park, MI 48101.
Cancer. 1993 Nov 15;72(10):3012-9. doi: 10.1002/1097-0142(19931115)72:10<3012::aid-cncr2820721025>3.0.co;2-y.
DNA ploidy analysis has been investigated as a prognostic indicator in prostate cancer. Most of the data is derived from retrospective studies using paraffin-embedded tissue. This method has drawbacks related to the quality of DNA histograms and uncontrolled data collection.
DNA ploidy analysis of freshly resected prostatic tissue was prospectively compared with conventional prognostic variables in 97 men treated with radical prostatectomy for localized prostate cancer.
Regarding the patients, 31.9% were African American and 66% had pathologic Stages C or D1 disease. Only 9.6% of patients with Stages A2 and B had a prostate-specific antigen (PSA) value greater than 10 ng/ml, whereas 97% of patients with PSA values greater than 20 ng/ml had pathologic Stages C and D1. PSA levels correlated with Gleason score (P = < 0.05); 51% and 100% of patients with Gleason score 5-7 and 8-10, respectively, had PSA values greater than 10 ng/ml. Twenty-two patients (23%) had DNA aneuploid tumors. Comparisons of mechanical to enzymatic cell suspensions indicated that DNA aneuploidy was better preserved in mechanical cell preparations. DNA ploidy correlated with pathologic stage (P = < 0.05) and Gleason score (P = < 0.05). Fifteen of 79 patients (18.9%) with Gleason score 5-7 had DNA aneuploid tumors versus 71.4% of patients with Gleason score 8-10. PSA groups correlated with ploidy status (P = 0.01). Although the majority of patients (19 of 22) with DNA aneuploid tumors had elevated preoperative PSA levels, none had a PSA value greater than 50 ng/ml.
DNA ploidy analysis correlated with established prognostic indicators in prostate cancer; however, its independent correlation with natural history and treatment outcome must be established for it to have an effect on therapeutic decisions.
DNA倍体分析已被作为前列腺癌的一项预后指标进行研究。大多数数据来自使用石蜡包埋组织的回顾性研究。该方法存在与DNA直方图质量及数据收集未受控制相关的缺点。
对97例因局限性前列腺癌接受根治性前列腺切除术的男性患者，前瞻性地比较新鲜切除前列腺组织的DNA倍体分析结果与传统预后变量。
在这些患者中，31.9%为非裔美国人，66%患有病理分期为C期或D1期的疾病。A2期和B期患者中只有9.6%的前列腺特异性抗原（PSA）值大于10 ng/ml，而PSA值大于20 ng/ml的患者中97%患有病理分期为C期和D1期的疾病。PSA水平与Gleason评分相关（P = < 0.05）；Gleason评分为5 - 7分和8 - 10分的患者中，分别有51%和100%的PSA值大于10 ng/ml。22例患者（23%）有DNA非整倍体肿瘤。机械法与酶解法细胞悬液的比较表明，机械法细胞制备中DNA非整倍性保存得更好。DNA倍体与病理分期（P = < 0.05）和Gleason评分（P = < 0.05）相关。Gleason评分为5 - 7分的79例患者中有15例（18.9%）有DNA非整倍体肿瘤，而Gleason评分为8 - 10分的患者中这一比例为71.4%。PSA分组与倍体状态相关（P = 0.01）。虽然大多数有DNA非整倍体肿瘤的患者（22例中的19例）术前PSA水平升高，但无一例PSA值大于50 ng/ml。
DNA倍体分析与前列腺癌既定的预后指标相关；然而，必须确定其与自然病程和治疗结果的独立相关性，才能对治疗决策产生影响。
