Toyota K
Department of Urology, Hokkaido University School of Medicine, Sapporo, Japan.
Hokkaido Igaku Zasshi. 1996 Jan;71(1):45-53.
This study was designed to evaluate the clinical relevance between the DNA ploidy and histopathology, and the incidence of the DNA heterogeneity in patients with bladder cancers. Flow cytometry(FCM) was used to study the DNA ploidy in 63 patients who underwent total cystectomy. The DNA ploidy and DNA index were analyzed by FCM in total 478 paraffin embedded samples (7.6 samples per case on the average). The DNA ploidy of 52 bladder cancers, that had coexisted after total cystectomy, showed that 24 cases, 46% were DNA aneuploid and 18 cases, 35% had DNA heterogeneity. The other 11 cases which were found to be pT0 after cystectomy were all DNA diploid. There were significantly good correlation among DNA ploidy pattern and intravesical involvement (lymph-duct involvement and venous involvement), but were not among the DNA ploidy pattern and tumor grade and stage. With regard to the evaluation of two vertically devided samples of tumors, DNA aneuploid had been not always recognized in the deeper samples, therefore, the author did not determine that there was good correlation between the DNA ploidy and the tumor invasion. In lymph node metastases, the 39 diploid tumors had given rise to lymph node metastases in only 5 cases(13%), whereas 11 cases(46%) of the 24 aneuploid tumors had metastasized(p < 0.01). Eleven of 16 lymph node metastases were DNA diploid and the others were DNA aneuploid. These data suggest that although the incidence of DNA heterogeneity in bladder cancers (35%) is thought to be relatively small, the DNA ploidy will be able to be the important prognosticating factor in bladder cancers.
本研究旨在评估膀胱癌患者DNA倍体与组织病理学之间的临床相关性,以及DNA异质性的发生率。采用流式细胞术(FCM)对63例行全膀胱切除术的患者进行DNA倍体研究。对总共478个石蜡包埋样本(平均每例7.6个样本)进行FCM分析,以检测DNA倍体和DNA指数。对全膀胱切除术后共存的52例膀胱癌的DNA倍体检测显示,24例(46%)为DNA非整倍体,18例(35%)存在DNA异质性。另外11例膀胱切除术后病理分期为pT0的病例均为DNA二倍体。DNA倍体模式与膀胱内侵犯(淋巴管侵犯和静脉侵犯)之间存在显著的良好相关性,但与肿瘤分级和分期之间不存在相关性。对于肿瘤垂直分割的两个样本的评估,在较深的样本中并非总能识别出DNA非整倍体,因此,作者未确定DNA倍体与肿瘤浸润之间存在良好相关性。在淋巴结转移方面,39例二倍体肿瘤中仅有5例(13%)发生淋巴结转移,而24例非整倍体肿瘤中有11例(46%)发生转移(p<0.01)。16例淋巴结转移病例中,11例为DNA二倍体,其余为DNA非整倍体。这些数据表明,尽管膀胱癌中DNA异质性的发生率(35%)相对较低,但DNA倍体仍可能是膀胱癌重要的预后因素。