Tomoda H, Baba H, Saito T, Wada S
Department of Gastroenterological Surgery, National Kyusyu Cancer Center, Fukuoka, Japan.
Dis Colon Rectum. 1998 Mar;41(3):286-90. doi: 10.1007/BF02237481.
To clarify the prognostic significance of the DNA content in cases of colorectal cancer, we investigated the relationship between the DNA content, as determined by the DNA ploidy or DNA index, and disease-free survival.
This study included 201 cases that were treated by curative surgery between 1989 and 1995 at our hospital. 68 were diploid and 133 were aneuploid. The mean DNA index of these tumors was 1.42. Recurrence occurred in 30 cases (14.9 percent). Tumor site, venous invasion, Dukes stage, DNA ploidy (diploid or aneuploid), and a DNA index (less than or greater than 1.4) correlated well with disease-free survival. A multivariable analysis suggested the DNA index to be a stronger predictor than DNA ploidy. Patients with aneuploid tumors had shorter disease-free survival than those with diploid tumors (P = 0.011), especially in Dukes Stage C cases (P = 0.0209). Patients with a DNA index greater than 1.4 also had a shorter disease-free survival than those with a DNA index less than 1.4 (P < 0.001), especially in Dukes Stage C cases (P = 0.0033).
The DNA index value (less than or greater than 1.4) seems to be a stronger predictor than DNA ploidy (diploid or aneuploid), and the combination of Dukes stage, tumor site, and a DNA index is, therefore, considered to be clinically valuable in predicting recurrence in cases of colorectal cancer.
为阐明结直肠癌病例中DNA含量的预后意义，我们研究了通过DNA倍体或DNA指数测定的DNA含量与无病生存期之间的关系。
本研究纳入了1989年至1995年间在我院接受根治性手术治疗的201例患者。68例为二倍体，133例为非整倍体。这些肿瘤的平均DNA指数为1.42。30例（14.9%）出现复发。肿瘤部位、静脉侵犯、Dukes分期、DNA倍体（二倍体或非整倍体）以及DNA指数（小于或大于1.4）与无病生存期密切相关。多变量分析表明，DNA指数比DNA倍体是更强的预测指标。非整倍体肿瘤患者的无病生存期短于二倍体肿瘤患者（P = 0.011），尤其是在Dukes C期病例中（P = 0.0209）。DNA指数大于1.4的患者的无病生存期也短于DNA指数小于1.4的患者（P < 0.001），尤其是在Dukes C期病例中（P = 0.0033）。
DNA指数值（小于或大于1.4）似乎比DNA倍体（二倍体或非整倍体）是更强的预测指标，因此，Dukes分期、肿瘤部位和DNA指数的组合被认为在预测结直肠癌病例的复发方面具有临床价值。
