Yamashita H, Noguchi S, Murakami N, Tsuji K, Yamaoka N, Sakamoto A
Department of Pathology, Oita Medical University, Japan.
Acta Pathol Jpn. 1993 Jan-Feb;43(1-2):22-7. doi: 10.1111/j.1440-1827.1993.tb02910.x.
The prognostic value of flow cytometry for thyroid papillary carcinoma in aged patients was studied and compared with that of tumor histology. Seventy-five surgically removed primary papillary thyroid carcinomas larger than 30 mm in diameter were obtained from patients over 60 years of age. A subtotal thyroidectomy with modified radical neck dissection was performed in all patients. Sixteen female patients died of the carcinoma (non-survivors) and 18 survived longer than 12 years without recurrence (survivors). Histologically, papillary carcinoma was subclassified into poorly and well differentiated types, and the presence of stromal bone formation was noted. Flow cytometry was performed using paraffin-embedded materials. The incidence of the poorly differentiated type was 2/18 among the tumors of survivors and 6/16 among the tumors of non-survivors (P = 0.08). Stromal bone formation was only found in the tumors of the survivors (6/18 and 0/16; P = 0.014). In flow cytometry, tumors of the survivors showed a DNA diploid pattern (14/14), whereas half of the tumors of non-survivors (6/12) showed an aneuploid pattern (P = 0.004). Moreover, in the remaining six tumors of the non-survivors, two showed a third peak at 6C and one showed a higher S fraction. Therefore, only three showed a DNA diploid pattern that was indistinguishable from that of the survivors. These results suggest that flow cytometry is useful for estimating the prognosis of thyroid papillary carcinoma.
研究了流式细胞术对老年甲状腺乳头状癌的预后价值，并与肿瘤组织学的预后价值进行了比较。从60岁以上患者中获取了75例手术切除的直径大于30mm的原发性甲状腺乳头状癌。所有患者均行甲状腺次全切除术加改良根治性颈清扫术。16例女性患者死于该癌（非幸存者），18例存活超过12年且无复发（幸存者）。组织学上，乳头状癌被分为低分化型和高分化型，并记录了间质骨形成的情况。使用石蜡包埋材料进行流式细胞术检测。在幸存者的肿瘤中，低分化型的发生率为2/18，在非幸存者的肿瘤中为6/16（P = 0.08）。间质骨形成仅在幸存者的肿瘤中发现（6/18和0/16；P = 0.014）。在流式细胞术中，幸存者的肿瘤显示DNA二倍体模式（14/14），而非幸存者的肿瘤中有一半（6/12）显示非整倍体模式（P = 0.004）。此外，在非幸存者的其余6个肿瘤中，2个在6C处显示第三个峰，1个显示较高的S期分数。因此，只有3个显示出与幸存者无法区分的DNA二倍体模式。这些结果表明，流式细胞术有助于评估甲状腺乳头状癌的预后。
