Pinto A E, André S, Nogueira M, Mendonça E, Soares J
Departamento de Patologia Morfológica, Instituto Português de Oncologia de Francisco, Gentil, Lisboa, Portugal.
J Clin Pathol. 1997 Jul;50(7):591-5. doi: 10.1136/jcp.50.7.591.
Breast tumours with a DNA content higher than 4N (hypertetraploidy) are not well characterised. The aim of this study was to evaluate the clinical and biological characteristics of 51 hypertetraploid breast carcinomas selected from a series of 860 consecutive cases analysed by flow cytometry.
The clinicopathological characteristics of the hypertetraploid group were compared with those of a control group of 138 non-hypertetraploid breast carcinomas. Breast tumours from patients submitted to surgery as primary therapeutic approach (15 hypertetraploid and the 138 non-hypertetraploid) were TNM staged and classified according to the histological type and grade. The remaining 36 patients had advanced neoplastic disease at presentation and were classified by cytological criteria only. DNA flow cytometric analysis was performed on fresh-frozen samples stained with propidium iodide. Hormone receptors were analysed by immunocytochemistry.
The incidence of hypertetraploid breast tumours was 5.9% (51 of 860). All the patients were women and the mean age at diagnosis was 65 years. There was a family history of breast cancer in 21.6% of cases. In the group of operated patients, 33.3% had pT3 tumours and 53.3% had axillary lymph node metastases. All but one tumour were invasive ductal carcinomas; the remaining was an invasive papillary carcinoma. Ten (66.7%) tumours were classified as poorly differentiated carcinomas. Oestrogen and progesterone receptors were negative in 33 (64.7%) and 38 (74.5%) tumours, respectively. At last follow up, 35 (72.9%) patients were alive, while 13 (27.1%) died of disease within three years of diagnosis. Statistical comparison of the clinicopathological features of hypertetraploid v non-hypertetraploid breast carcinomas yielded a significant difference in tumour size (p < 0.001), histological grade (p < 0.001), hormone receptor status (p < 0.001), and overall survival (p < 0.001) between the two groups.
Flow cytometric DNA hypertetraploidy is related to clinicopathological features of breast cancer usually associated with unfavourable prognosis.
DNA含量高于4N（超四倍体）的乳腺肿瘤特征尚不明确。本研究旨在评估从860例连续病例中选取的51例超四倍体乳腺癌的临床和生物学特征，这些病例均通过流式细胞术进行分析。
将超四倍体组的临床病理特征与138例非超四倍体乳腺癌对照组进行比较。以手术作为主要治疗方法的患者的乳腺肿瘤（15例超四倍体和138例非超四倍体）进行TNM分期，并根据组织学类型和分级进行分类。其余36例患者初诊时患有晚期肿瘤疾病，仅根据细胞学标准进行分类。对用碘化丙啶染色的新鲜冷冻样本进行DNA流式细胞术分析。通过免疫细胞化学分析激素受体。
超四倍体乳腺肿瘤的发生率为5.9%（860例中的51例）。所有患者均为女性，诊断时的平均年龄为65岁。21.6%的病例有乳腺癌家族史。在手术患者组中，33.3%有pT3肿瘤，53.3%有腋窝淋巴结转移。除1例肿瘤外，其余均为浸润性导管癌；其余为浸润性乳头状癌。10例（66.7%）肿瘤被分类为低分化癌。雌激素和孕激素受体分别在33例（64.7%）和38例（74.5%）肿瘤中呈阴性。在最后一次随访时，35例（72.9%）患者存活，而13例（27.1%）在诊断后三年内死于疾病。超四倍体与非超四倍体乳腺癌的临床病理特征的统计学比较显示，两组在肿瘤大小（p<0.001）、组织学分级（p<0.001）、激素受体状态（p<0.001）和总生存期（p<0.001）方面存在显著差异。
流式细胞术检测的DNA超四倍体与通常预后不良的乳腺癌临床病理特征相关。
