流式细胞术DNA倍体和S期分数与结直肠癌肿瘤行为的组织病理学指标相关。

Flow cytometric DNA ploidy and S-phase fraction correlate with histopathologic indicators of tumor behavior in colorectal carcinoma.

作者信息

Pinto A E, Chaves P, Fidalgo P, Oliveira A G, Leitão C N, Soares J

机构信息

Departamento de Patologia Morfológica, Instituto Português de Oncologia de Francisco Gentil, Lisboa, Portugal.

出版信息

Dis Colon Rectum. 1997 Apr;40(4):411-9. doi: 10.1007/BF02258385.

DOI:10.1007/BF02258385

PMID:9106689

Abstract

BACKGROUND

The clinical behavior of colorectal carcinoma is highly variable without reliable predictive biomarkers. Previous reports have shown that flow cytometric DNA analysis may provide valuable prognostic information in these tumors.

PURPOSE AND METHODS

This study evaluates the DNA ploidy and the S-phase fraction (SPF) on frozen samples obtained from 61 patients with colorectal carcinoma by using flow cytometry, and it correlates the data with histopathologic features known to affect disease prognosis. Tumors were classified using the World Health Organization's histologic criteria and were staged according the American Joint Committee on Cancer's classification system. Grade of the neoplasm, vascular invasion, and perineural tumor spread were evaluated in every case.

RESULTS

Fifty-nine percent of tumors were aneuploid and showed statistically significant higher S-phase values than diploid tumors (22.5 vs. 11.2 percent; P < 0.00001). Mean SPF of the whole series was 17.9 (range, 4.2-44.2) percent. A statistically significant association was found between SPF values and histologic grade (P < 0.0016), nodal status (P < 0.0007), distant metastasis (P < 0.0001), tumor stage (P < 0.0001), venous invasion (P < 0.0002), and lymphatic permeation (P < 0.01) but not with perineural growth and infiltration of the neoplasm through the bowel wall (T). DNA ploidy correlated positively with tumor stage (P < 0.03), and the association between aneuploidy and advanced stages of the disease was statistically significant.

CONCLUSIONS

These findings showed that flow cytometric DNA ploidy and SPF, evaluated in fresh samples, are potentially useful parameters to estimate colorectal carcinoma biopathology. Aneuploidy and high replicative neoplastic activity correlated with histopathologic features that are commonly associated with the prognosis of colorectal carcinoma, being SPF-related to disease dissemination and, therefore, an indicator of clinical relevance.

摘要

背景

结直肠癌的临床行为高度可变，缺乏可靠的预测生物标志物。既往报道显示，流式细胞术DNA分析可能为这些肿瘤提供有价值的预后信息。

目的和方法

本研究采用流式细胞术评估了61例结直肠癌患者冷冻样本的DNA倍体和S期分数（SPF），并将数据与已知影响疾病预后的组织病理学特征相关联。肿瘤根据世界卫生组织的组织学标准进行分类，并根据美国癌症联合委员会的分类系统进行分期。对每例病例评估肿瘤分级、血管侵犯和神经周围肿瘤扩散情况。

结果

59%的肿瘤为非整倍体，其S期值在统计学上显著高于二倍体肿瘤（22.5%对11.2%；P<0.00001）。整个系列的平均SPF为17.9%（范围4.2 - 44.2%）。在SPF值与组织学分级（P<0.0016）、淋巴结状态（P<0.0007）、远处转移（P<0.0001）、肿瘤分期（P<0.0001）、静脉侵犯（P<0.0002）和淋巴管浸润（P<0.01）之间发现了统计学上的显著关联，但与神经周围生长及肿瘤通过肠壁的浸润（T）无关。DNA倍体与肿瘤分期呈正相关（P<0.03），非整倍体与疾病晚期之间的关联具有统计学意义。