Ando Y, Tsuchiya A, Oki S, Sato H, Yoshida T, Kimijima I, Abe R
Dept. of Surgery 2, Fukushima Medical College, Japan.
Gan To Kagaku Ryoho. 1996 Jun;23 Suppl 2:112-7.
Significance of flow cytometric DNA analysis for assessing malignant potential and survival of colorectal cancer was investigated using paraffin-embedded materials from 163 patients who underwent resection of curability A from 1971 to 1985, excluding intramucosal carcinoma. DNA diploid was confirmed in 46% (75 cases) of the patients and DNA aneuploid in 54% (88 cases). No significant correlation was seen between DNA ploidy and clinicopathological factors, such as tumor location, macroscopic type, histological type, depth of invasion, lymph node metastasis and stage. Cumulative survival rates after curable resection of colorectal cancer were significantly lower in patients with DNA aneuploid tumor than those with DNA diploid tumor. Furthermore, in patients in stage of II and III, survival rates were lower in DNA aneuploid patients than DNA diploid patients, respectively. A multivariate analysis of survival data using Cox's proportional hazard model showed that DNA ploidy was the significant discriminating factor on survival in stage II and III cancer. In conclusion, nuclear DNA ploidy in patients with stage II and III colorectal cancer undergoing curable resection may represent malignant potential and may be an independent prognostic factor.
利用1971年至1985年间接受A期根治性切除的163例患者(不包括黏膜内癌)的石蜡包埋材料,研究了流式细胞术DNA分析对评估结直肠癌恶性潜能和生存情况的意义。46%(75例)的患者证实为DNA二倍体,54%(88例)为DNA非整倍体。DNA倍体与肿瘤位置、大体类型、组织学类型、浸润深度、淋巴结转移及分期等临床病理因素之间未见显著相关性。结直肠癌根治性切除术后,DNA非整倍体肿瘤患者的累积生存率显著低于DNA二倍体肿瘤患者。此外,在II期和III期患者中,DNA非整倍体患者的生存率分别低于DNA二倍体患者。使用Cox比例风险模型对生存数据进行多因素分析显示,DNA倍体是II期和III期癌症生存的显著鉴别因素。总之,接受根治性切除的II期和III期结直肠癌患者的核DNA倍体可能代表恶性潜能,且可能是一个独立的预后因素。