Grignon D J, Abdel-Malak M, Mertens W, Koster J, Keeney M, Sakr W, Shepherd R R
Department of Pathology, Victoria Hospital, London, Canada.
Mod Pathol. 1995 Jan;8(1):18-24.
DNA aneuploidy has repeatedly been shown to be a significant prognostic indicator in renal cell carcinoma; however, few studies have emphasized the importance of measurements of cellular proliferation. This study evaluated 55 patients treated by radical nephrectomy and for whom clinical follow-up was available. There were 36 men and 19 women with a mean age of 61 yr. Robson stage distribution was I, 38 cases; II, five cases; and III, 12 cases. Flow cytometric analysis in 44 cases revealed 29 DNA diploid and 15 DNA aneuploid tumors with a median synthesis-phase fraction (SPF) of 4.4% (range 1.0 to 31.4%). The median proliferating cell nuclear antigen index was 3.9% (range 0.1 to 58.0%). There was a significant correlation between SPF and proliferating cell nuclear antigen index (R = 0.769) in the 33 cases in which both were available. Cellular proliferation, as determined by SPF, was a significant prognostic indicator (P < 0.02), but proliferating cell nuclear antigen index did not correlate with outcome (P > 0.05). Other significant predictors in this study were Robson stage (P = 0.03) and nuclear grade (P = 0.0003). DNA ploidy did not correlate with outcome (P > 0.05). We conclude that cellular proliferation, as measured by SPF analysis, is a significant predictor of outcome for renal cell carcinoma. Although the proliferating cell nuclear antigen index correlated with SPF, it did not achieve statistical significance as a prognostic indicator.
DNA非整倍体已多次被证明是肾细胞癌的一个重要预后指标；然而，很少有研究强调细胞增殖测量的重要性。本研究评估了55例接受根治性肾切除术且有临床随访资料的患者。其中男性36例，女性19例，平均年龄61岁。罗布森分期分布为：I期38例；II期5例；III期12例。44例患者的流式细胞术分析显示，29例为DNA二倍体肿瘤，15例为DNA非整倍体肿瘤，合成期分数（SPF）中位数为4.4%（范围1.0%至31.4%）。增殖细胞核抗原指数中位数为3.9%（范围0.1%至58.0%）。在可同时获得SPF和增殖细胞核抗原指数的33例病例中，两者之间存在显著相关性（R = 0.769）。由SPF确定的细胞增殖是一个重要的预后指标（P < 0.02），但增殖细胞核抗原指数与预后无关（P > 0.05）。本研究中的其他重要预后指标是罗布森分期（P = 0.03）和核分级（P = 0.0003）。DNA倍体与预后无关（P > 0.05）。我们得出结论，通过SPF分析测量的细胞增殖是肾细胞癌预后的一个重要预测指标。虽然增殖细胞核抗原指数与SPF相关，但作为预后指标未达到统计学意义。
