Salmon I, Gasperin P, Remmelink M, Rahier I, Rocmans P, Pasteels J L, Heimann R, Kiss R
Department of Pathology, Hospital Erasme, Brussels, Belgium.
Hum Pathol. 1993 Aug;24(8):912-20. doi: 10.1016/0046-8177(93)90143-5.
This study describes the ploidy level and proliferation rate in a series of 74 multinodular goiters (MNGs), 17 cases of Hashimoto's disease, 33 cases of Basedow's disease, 113 adenomas, 139 primary carcinomas, and 31 cervical lymph node metastases from 376 patients. Both ploidy level and proliferation rate were assessed by digital cell image analyses of Feulgen-stained nuclei from formalin-fixed, paraffin-embedded tissues. The ploidy level of each sample was assessed using both its DNA index and its DNA histogram type. The proliferation index assessments corresponded to the determination of the proportion of cells in the S-phase fraction. The data reveal that the proportion of aneuploid cases increases according to the following sequence: simple MNGs and normomacrovesicular adenomas-->MNGs with adenomatous hyperplasia and microvesicular adenomas and Hürthle cell adenomas-->papillary and Hürthle cell carcinomas-->follicular and medullary carcinomas-->anaplastic carcinomas. This suggests the preneoplastic nature of the microvesicular adenomas and even of MNGs with adenomatous hyperplasia. The ploidy levels of 99% of the 407 cases of the thyroid tumor series could be described using six DNA histogram types: diploid, hyperdiploid, triploid, hypertriploid, tetraploid, and polymorphic. It was possible to assess the proliferation rate of 279 samples. The results show that a significantly higher proportion of malignant compared with benign thyroid tumors (35.5% v 10.5%, respectively) exhibited a proliferation index higher than 5%, and that, whether benign or malignant, the hypertriploid thyroid tumors proliferated significantly less than the nonhypertriploid thyroid tumors.
本研究描述了376例患者的74例多结节性甲状腺肿(MNG)、17例桥本氏病、33例巴塞多氏病、113例腺瘤、139例原发性癌以及31例颈部淋巴结转移的倍体水平和增殖率。通过对福尔马林固定、石蜡包埋组织中Feulgen染色细胞核进行数字细胞图像分析来评估倍体水平和增殖率。使用DNA指数及其DNA直方图类型评估每个样本的倍体水平。增殖指数评估对应于S期细胞比例的测定。数据显示,非整倍体病例的比例按以下顺序增加:单纯MNG和正常大泡性腺瘤→伴有腺瘤样增生的MNG、微泡性腺瘤和许特莱细胞腺瘤→乳头状癌和许特莱细胞癌→滤泡癌和髓样癌→未分化癌。这表明微泡性腺瘤甚至伴有腺瘤样增生的MNG具有肿瘤前体性质。407例甲状腺肿瘤系列中99%的病例的倍体水平可用六种DNA直方图类型描述:二倍体、超二倍体、三倍体、超三倍体、四倍体和多态性。可以评估279个样本的增殖率。结果显示,与良性甲状腺肿瘤相比,恶性甲状腺肿瘤中增殖指数高于5%的比例显著更高(分别为35.5%和10.5%),并且,无论良性还是恶性,超三倍体甲状腺肿瘤的增殖明显少于非超三倍体甲状腺肿瘤。