Deans G T, Williamson K, Hamilton P, Heatley M, Arthurs K, Patterson C C, Rowlands B J, Parks T G, Spence R A
Department of Surgery, Belfast City Hospital, Queen's University of Belfast.
Gut. 1993 Nov;34(11):1566-71. doi: 10.1136/gut.34.11.1566.
DNA analysis was assessed by densitometry for 281 cases of colorectal adenocarcinoma. Detection of aneuploidy in a single case rose from 65% if one, to 92.5% when three or more sections, were analysed. Although aneuploid tumours had significantly larger nuclear areas than near diploid tumours (p = 0.009), densitometric measurements showed no association with clinicopathological variables. DNA content determined by densitometry was compared with that from flow cytometry on 465 tissue sections from 241 cases. Aneuploidy assessed by flow cytometry was significantly associated with that determined by densitometry (p < 0.01 for all comparisons), ploidy state being similar in 381 sections (82%, kappa = 0.63, p < 0.001), and 187 cases (77.6%, kappa = 0.57, p < 0.001). Univariate survival analysis showed that DNA densitometric variables had no significant association with survival in (a) all cases, (b) cases without lymph node metastases, or (c) cases without distant metastases. Multivariate regression analysis of densitometric and clinicopathological variables identified Dukes's stage, patient age, and tumour differentiation as the combination of variables most closely related to survival. Densitometric measurement of DNA content could not significantly improve on the prognostic model containing these three variables. It is concluded that, although the assessment of DNA content by densitometry is comparable with that of flow cytometry, conventional histological variables remain the best predictors of prognosis in colorectal cancer.
对281例结肠直肠癌病例进行了光密度测定法的DNA分析。若分析一个切片，单例非整倍体的检测率为65%，若分析三个或更多切片，该检测率则升至92.5%。尽管非整倍体肿瘤的核面积显著大于近二倍体肿瘤（p = 0.009），但光密度测定结果与临床病理变量并无关联。对来自241例患者的465个组织切片，将通过光密度测定法确定的DNA含量与通过流式细胞术确定的DNA含量进行了比较。通过流式细胞术评估的非整倍体与通过光密度测定法确定的非整倍体显著相关（所有比较的p < 0.01），在381个切片中倍体状态相似（82%，kappa = 0.63，p < 0.001），在187例患者中也相似（77.6%，kappa = 0.57，p < 0.001）。单因素生存分析显示，DNA光密度测定变量与以下情况的生存均无显著关联：（a）所有病例；（b）无淋巴结转移的病例；或（c）无远处转移的病例。对光密度测定和临床病理变量进行多因素回归分析发现， Dukes分期、患者年龄和肿瘤分化是与生存最密切相关的变量组合。DNA含量的光密度测定无法显著改善包含这三个变量的预后模型。得出的结论是，尽管通过光密度测定法评估DNA含量与通过流式细胞术评估相当，但传统组织学变量仍是结肠直肠癌预后的最佳预测指标。
