Akervall J, Jin Y, Baldetorp B, Mertens F, Wennerberg J
Department of Otorhinolaryngology & Head and Neck Surgery, University Hospital, Lund, Sweden.
Br J Cancer. 1998 Apr;77(7):1082-8. doi: 10.1038/bjc.1998.180.
In squamous cell carcinoma of the head and neck (SCCHN), DNA ploidy as determined by flow cytometry (FCM) has been found to yield prognostic information but only for tumours at oral sites. Cytogenetic findings have indicated complex karyotype to be a correlate of poor clinical outcome. In the present study, 73 SCCHN were investigated with the two techniques. Aneuploid cell populations were identified in 49 (67%) cases by FCM but in only 21 (29%) cases by cytogenetic analysis. The chromosome index (CI), calculated as the mean chromosome number divided by 46, was compared with the respective DNA index (DI) obtained by FCM in 15 tumours, non-diploid according to both techniques, DI being systematically 12% higher than CI in this subgroup. Eight (33%) of the 24 tumours diploid according to FCM had complex karyotypes, three of the tumours being cytogenetically hypodiploid, three diploid and two non-diploid. The findings in the present study may partly explain the low prognostic value of ploidy status as assessed by FCM that has been observed in SCCHN. In addition, we conclude that FCM yields information of the genetic changes that is too unspecific, and that cytogenetic analysis shows a high rate of unsuccessful investigations, thus diminishing the value of the two methods as prognostic factors in SCCHN.
在头颈部鳞状细胞癌(SCCHN)中,通过流式细胞术(FCM)测定的DNA倍性已被发现可提供预后信息,但仅适用于口腔部位的肿瘤。细胞遗传学研究结果表明,复杂核型与不良临床结局相关。在本研究中,使用这两种技术对73例SCCHN进行了调查。通过FCM在49例(67%)病例中鉴定出非整倍体细胞群,而通过细胞遗传学分析仅在21例(29%)病例中鉴定出。将染色体指数(CI)(计算方法为平均染色体数除以46)与通过FCM在15个肿瘤中获得的各自DNA指数(DI)进行比较,这15个肿瘤根据两种技术均为非二倍体,在该亚组中DI系统性地比CI高12%。根据FCM为二倍体的24个肿瘤中有8个(33%)具有复杂核型,其中3个肿瘤在细胞遗传学上为亚二倍体,3个为二倍体,2个为非二倍体。本研究结果可能部分解释了在SCCHN中观察到的通过FCM评估的倍性状态预后价值较低的原因。此外,我们得出结论,FCM产生的遗传变化信息过于不特异,并且细胞遗传学分析显示未成功检测的比例很高,从而降低了这两种方法作为SCCHN预后因素的价值。