Díaz Aguirregoitia F J, García-Alonso Montoya I, Iturburu Belmonte I, Portugal Porras V, Alonso Varona A, Echevarría García-Sanfrechoso A, Méndez Martín J
Departamento de Cirugía, Radiología y Medicina Física, Hospital de Cruces (Servicio de Cirugía A).
Rev Esp Enferm Dig. 1993 Jun;83(6):421-8.
The aim of this study was to look for correlations between nuclear DNA content of colo-rectal tumors, and such clinical parameters as age, sex, location, CEA, histological grade and Duke's stages.
A prospective study is carried out on surgical patients, subjected to standard criteria of radicality. Nuclear DNA content was quantified in tumoral cells by microcytophotometric techniques.
106 patients with colo-rectal cancer. Patients with colonic perforation, other concomitant neoplasia, non-curative surgery or receiving adjuvant therapies were excluded from the study. Five patients died during the postoperative period and one was lost.
Histological grade: 28% G1, 35% G2 and 37% G3. Dukes': 8% A, 40% B, 32% C and 20% D. DNA quantification has rendered 45% as euploid and 55% as aneuploid. There was no statistical correlation between ploidy and location, age, sex or CEA. However, there is a clear preponderance of euploid tumors in G1 (23 vs. 5), while the aneuploid tumors double the euploid ones (24 and 25 vs. 12 and 12) in G2 and G3. A similar result was found comparing ploidy and Dukes: euploid tumors reach 77% both in stages A and B, while they drop to 24% and 14% in stages C and D. It has also been found that euploid tumors show a longer period of survival free of recurrence.
Evidence has been found supporting a prognostic value for tumoral DNA quantification in colo-rectal cancer. A longer follow-up is required to study absolute survival of the patients.
本研究旨在探寻结直肠癌细胞核DNA含量与年龄、性别、肿瘤位置、癌胚抗原(CEA)、组织学分级及杜克分期等临床参数之间的相关性。
对符合根治性标准的外科手术患者进行前瞻性研究。采用微细胞光度测定技术对肿瘤细胞中的细胞核DNA含量进行定量分析。
106例结直肠癌患者。结肠穿孔患者、其他合并肿瘤患者、非根治性手术患者或接受辅助治疗的患者被排除在研究之外。5例患者在术后死亡,1例失访。
组织学分级:28%为G1级,35%为G2级,37%为G3级。杜克分期:8%为A期,40%为B期,32%为C期,20%为D期。DNA定量分析显示45%为整倍体,55%为非整倍体。倍体与肿瘤位置、年龄、性别或CEA之间无统计学相关性。然而,G1级肿瘤中整倍体肿瘤明显占优势(23例对5例),而在G2级和G3级中,非整倍体肿瘤数量是整倍体肿瘤的两倍(24例和25例对12例和12例)。比较倍体与杜克分期也发现了类似结果:A期和B期整倍体肿瘤均占77%,而在C期和D期分别降至24%和14%。还发现整倍体肿瘤的无复发生存期更长。
已找到证据支持肿瘤DNA定量分析对结直肠癌具有预后价值。需要更长时间的随访来研究患者的绝对生存率。