Miyakawa A, Tachibana M, Nakashima J, Deguchi N, Baba S, Tazaki H
Department of Urology, School of Medicine, Keio University, Tokyo, Japan.
J Urol. 1994 Jul;152(1):76-80. doi: 10.1016/s0022-5347(17)32821-5.
We previously reported that flow cytometric bromodeoxyuridine/deoxyribonucleic acid (DNA) bivariate analysis can provide important information on the malignant potential of bladder cancer. Therefore, in the current study we further evaluated upper tract urothelial tumors to clarify whether DNA/bromodeoxyuridine bivariate analysis can provide additional prognostic information on patients with upper tract urothelial tumor. A total of 43 upper tract urothelial tumors that were resected by nephroureterectomy was analyzed. Flow cytometric DNA ploidy and bromodeoxyuridine labeling were determined by an in vitro bromodeoxyuridine labeling method. DNA diploid tumors were associated with an 85.9% 3-year survival rate compared to 36.5% for DNA aneuploid tumors. On the other hand, 11 high bromodeoxyuridine labeled tumors demonstrated a 16.4% 3-year survival rate compared to 82.4% for those with low bromodeoxyuridine labeled tumors. Multivariate survival analysis using the Cox proportional regression model was performed to identify the most informative factors for prognosis, with the single most important factor being histological tumor stage. Nearly as important and the next factor to be chosen was tumor grade, followed by bromodeoxyuridine labeling index status. DNA ploidy status did not influence clinical outcome. Thereafter, when actuarial 3-year survival rates according to the bromodeoxyuridine labeling index status in grade 3 tumors were estimated, 68.4% and 16.7% 3-year survival rates were observed in cases of low and high bromodeoxyuridine labeling index tumors, respectively. These results indicate that flow cytometric bromodeoxyuridine/DNA bivariate analysis may be useful in dividing patients with grade 3 upper tract urothelial carcinoma into 2 different prognosis groups.
我们之前报道过，流式细胞术溴脱氧尿苷/脱氧核糖核酸（DNA）双变量分析可为膀胱癌的恶性潜能提供重要信息。因此，在本研究中，我们进一步评估上尿路尿路上皮肿瘤，以明确DNA/溴脱氧尿苷双变量分析是否可为上尿路尿路上皮肿瘤患者提供额外的预后信息。共分析了43例通过肾输尿管切除术切除的上尿路尿路上皮肿瘤。采用体外溴脱氧尿苷标记法测定流式细胞术DNA倍体和溴脱氧尿苷标记情况。DNA二倍体肿瘤的3年生存率为85.9%，而DNA非整倍体肿瘤为36.5%。另一方面，11例高溴脱氧尿苷标记肿瘤的3年生存率为16.4%，而低溴脱氧尿苷标记肿瘤为82.4%。使用Cox比例回归模型进行多变量生存分析，以确定预后最具信息量的因素，其中最重要的单一因素是组织学肿瘤分期。几乎同样重要且接下来要选择的因素是肿瘤分级，其次是溴脱氧尿苷标记指数状态。DNA倍体状态不影响临床结果。此后，根据3级肿瘤的溴脱氧尿苷标记指数状态估计精算3年生存率时，低溴脱氧尿苷标记指数肿瘤和高溴脱氧尿苷标记指数肿瘤的3年生存率分别为68.4%和16.7%。这些结果表明，流式细胞术溴脱氧尿苷/DNA双变量分析可能有助于将3级上尿路尿路上皮癌患者分为2个不同的预后组。
