Omejc M, Repse S, Bracko M
Department of Gastroenterologic Surgery, University Medical Center, Ljubljana, Slovenia.
J Surg Oncol. 1997 Aug;65(4):237-41. doi: 10.1002/(sici)1096-9098(199708)65:4<237::aid-jso3>3.0.co;2-6.
The relevance of DNA ploidy as a prognostic factor in patients with gastric cancer is controversial. The prognostic significance of DNA ploidy and its relationship to conventional histological grading and staging of the tumor (TNM stage, Lauren, Ming and WHO classification) were evaluated.
DNA ploidy of the tumor was determined by flow cytometry on archival material from 76 patients who underwent R0, D2 stomach resection.
DNA aneuploidy was found in 39 cases (51%). No significant association between DNA aneuploidy and either patients' sex, pT, pN, type according to Ming or Borrmann and tumor localization was found. The incidence of DNA aneuploidy was significantly lower in tumors of diffuse type according to Lauren, in signet-ring cell or undifferentiated type (WHO), in grade 3/4 tumors, and in patients younger than 50 years. We found no significant difference in survival of patients with DNA aneuploid when compared to DNA diploid tumors, although the prognosis of the patients with lower DNA index (DI < 1.2) tended to be better than that of higher DNA index (DI > 1.2).
DNA ploidy appears to be of limited prognostic value after R0, D2 resection of stomach cancer.
DNA倍性作为胃癌患者预后因素的相关性存在争议。本研究评估了DNA倍性的预后意义及其与肿瘤传统组织学分级和分期（TNM分期、劳伦分型、明氏分型和世界卫生组织分类）的关系。
采用流式细胞术对76例行R0、D2胃切除术患者的存档材料进行肿瘤DNA倍性检测。
39例（51%）患者检测到DNA非整倍体。未发现DNA非整倍体与患者性别、pT、pN、明氏分型或Borrmann分型及肿瘤部位之间存在显著关联。根据劳伦分型，弥漫型肿瘤、印戒细胞或未分化型（世界卫生组织）肿瘤、3/4级肿瘤以及年龄小于50岁患者的DNA非整倍体发生率显著较低。与DNA二倍体肿瘤患者相比，DNA非整倍体患者的生存率无显著差异，尽管DNA指数较低（DI < 1.2）的患者预后往往优于DNA指数较高（DI > 1.2）的患者。
在胃癌行R0、D2切除术后，DNA倍性的预后价值似乎有限。
