Zoras O I, Curti G, Cooke T G, Vlachonikolis I G, Forster G, McArdle C S, Stanton P D
University Department of Surgery Royal Infirmary, Glasgow, UK.
Surg Oncol. 1994 Dec;3(6):345-9. doi: 10.1016/0960-7404(94)90073-6.
Tumour ploidy is of prognostic value in colorectal cancer, DNA aneuploid tumours having a worse outlook. Nearly all studies have concentrated on the DNA content of the primary tumour. We have examined the ploidy of the primary tumour and its lymph node metastases in 71 cases of Dukes' stage C disease, to see whether this provides greater prognostic information than the primary alone. Analysis was performed using formalin-fixed, paraffin-embedded tumour sections. Ploidy of primary and metastases was different in 20 cases (28%), aneuploid nodes being seen with diploid primaries and vice versa. Ploidy of both the primary (chi 2 = 4.86, P = 0.03) and secondary (chi 2 = 4.86, P = 0.03) tumours predicted survival in univariate analysis. Combining the ploidy of primary and nodes, three prognostic groups could be defined--diploid primaries with diploid metastases (hazard relative to both aneuploid, 0.36) had significantly better survival than cases where the ploidy of the primary and nodes were mixed (relative hazard 0.47-0.56), which did better than cases with aneuploid primary and nodes. This study demonstrates that ploidy variation between primary and secondary tumours is common, and better prognostic information may be gained by studying both.
肿瘤倍性在结直肠癌中具有预后价值，DNA非整倍体肿瘤的预后较差。几乎所有研究都集中在原发性肿瘤的DNA含量上。我们检测了71例Dukes C期疾病患者原发性肿瘤及其淋巴结转移灶的倍性，以确定这是否比单独研究原发性肿瘤能提供更多的预后信息。分析采用福尔马林固定、石蜡包埋的肿瘤切片。20例（28%）患者的原发性肿瘤和转移灶倍性不同，出现二倍体原发性肿瘤伴有非整倍体转移淋巴结，反之亦然。在单因素分析中，原发性肿瘤（χ2 = 4.86，P = 0.03）和继发性肿瘤（χ2 = 4.86，P = 0.03）的倍性均能预测生存情况。综合原发性肿瘤和转移淋巴结的倍性，可以定义三个预后组——原发性二倍体伴有二倍体转移灶（相对于两个均为非整倍体的风险比为0.36）的患者生存率明显高于原发性肿瘤和转移淋巴结倍性混合的患者（相对风险为0.47 - 0.56），后者又优于原发性和转移淋巴结均为非整倍体的患者。本研究表明，原发性肿瘤和继发性肿瘤之间的倍性变化很常见，同时研究两者可能会获得更好的预后信息。
