Yang J L, Crowe P J, Ow K T, Ham J M, Crouch R L, Russell P J
Department of Surgery, Prince of Wales Hospital, University of NSW, Sydney, Australia.
J Gastroenterol Hepatol. 1996 Apr;11(4):319-24. doi: 10.1111/j.1440-1746.1996.tb01378.x.
The most common cause of death in patients with colorectal cancer is metastatic liver disease. In order to identify patients at a high risk of developing hepatic secondaries from colorectal cancers, DNA content was measured in metastasizing colorectal primaries (Group I, n = 32) as well as in their subsequently resected liver secondaries and in sections of non-metastasizing colorectal cancers (Group II, n = 25). A modified interpretation system involving both a DNA index and percentage of cycling cells (those in S and G2 + M phases) was developed. DNA content was measured in paraffin-embedded sections by flow cytometry using internal controls (human peripheral blood mononuclear cells) and non-malignant tissue controls (19 patients with diverticular disease). In Group I there were significantly more tumours with both abnormal ploidy (aneuploid or abnormal tetraploid peak) and > 15% cycling cells compared with Group II (Chi-squared; P = 0.034). The combination of abnormal ploidy and > 15% cycling cells was superior to Dukes' classification for identifying metastasizing tumours (Logistic Regression; P = 0.047). However, it was not possible to discriminate between the two groups using either DNA ploidy or the percentage of cycling cells alone. The metastasizing colorectal cancers exhibited similar DNA ploidy characteristics and had a similar percentage of cycling cells compared with their liver metastases. These results suggest that tumour DNA ploidy plus the percentage of cycling cells may predict the development of liver metastases and thus survival in patients with colorectal cancer.
结直肠癌患者最常见的死亡原因是肝转移。为了识别结直肠癌发生肝转移的高危患者，我们测定了发生转移的结直肠癌原发灶（第一组，n = 32）及其随后切除的肝转移灶以及未发生转移的结直肠癌组织切片（第二组，n = 25）的DNA含量。我们开发了一种改良的解读系统，该系统同时涉及DNA指数和循环细胞百分比（处于S期和G2 + M期的细胞）。通过流式细胞术在石蜡包埋切片中测量DNA含量，使用内部对照（人外周血单核细胞）和非恶性组织对照（19例憩室病患者）。与第二组相比，第一组中具有异常倍体（非整倍体或异常四倍体峰）且循环细胞> 15%的肿瘤明显更多（卡方检验；P = 0.034）。异常倍体和循环细胞> 15%的组合在识别转移瘤方面优于Dukes分期（逻辑回归；P = 0.047）。然而，单独使用DNA倍体或循环细胞百分比无法区分两组。发生转移的结直肠癌与其肝转移灶相比，表现出相似的DNA倍体特征和相似的循环细胞百分比。这些结果表明，肿瘤DNA倍体加上循环细胞百分比可能预测结直肠癌患者肝转移的发生以及生存情况。
