Scott C A, Desinan L, Avellini C, Bardus P, Rimondi G, Rizzi V, Beltrami C A
Institute of Pathology, University of Udine, Italy.
Hum Pathol. 1998 May;29(5):482-90. doi: 10.1016/s0046-8177(98)90064-8.
DNA index (DI) values seen in 86 sporadic colorectal adenocarcinomas were related to clinical, morphological, and disease progression features. DI, whose overall distribution was bimodal with peaks in the diploid and from hypotriploid to tetraploid ranges, was related to pathological lymph node staging (pN), staging, lymphoid reaction, and tubular configuration. With increasing severity in pathological features, an irregular shift in DI class prevalence was seen, with no steady increase from diploidy to higher degrees of aneuploidy. All UICC stage I tumors (13% of total) were aneuploid, 50% being hypertriploid; diploidy (35%) and hypertriploidy (22%) prevailed in stage II carcinomas (41% of total), diploidy (35%) and hypotriploidy (30%) in stage III (30% of total), and triploidy (33%) in stage IV (15% of total). Amongst features related to stage (lymphoid reaction, depth of neoplastic embolization, grading, tubular configuration, and polymorphism), few were associated with DI, and none influenced DI shift and class prevalence through the stages. The biological capabilities of colorectal adenocarcinoma in relation to stage are expressed by certain aneuploid DI classes (hypertriploidy: absence of extracolonic spread; hypotriploidy: lymph node metastases; triploidy: distant metastases). Diploidy is unrelated to criteria defining stage above I and predicts 50% of cases with development of metachronous metastases. Irregular DI class shift through the stages may be attributable to different pathways of cancerogenesis and disease progression in diploid versus aneuploid carcinomas. Alternatively, assuming that the diploid fraction in aneuploid tumors contains neoplastic cells, pure diploid carcinomas represent the selection of a vital clone that may give rise to a further mixed population whose aneuploid DI is different and best fitted to express the biological capabilities of that given stage.
在86例散发性结直肠癌中观察到的DNA指数（DI）值与临床、形态学及疾病进展特征相关。DI的总体分布呈双峰型，在二倍体以及从亚三倍体到四倍体范围内出现峰值，它与病理淋巴结分期（pN）、分期、淋巴样反应及管状结构有关。随着病理特征严重程度增加，可见DI类别患病率出现不规则变化，并非从二倍体到更高程度非整倍体呈稳定增加。所有国际抗癌联盟（UICC）I期肿瘤（占总数的13%）均为非整倍体，其中50%为超三倍体；II期癌（占总数的41%）中二倍体（35%）和超三倍体（22%）占优势，III期（占总数的30%）中二倍体（35%）和亚三倍体（30%）占优势，IV期（占总数的15%）中三倍体（33%）占优势。在与分期相关的特征（淋巴样反应、肿瘤栓塞深度、分级、管状结构及多态性）中，很少有与DI相关，且没有一个特征通过分期影响DI变化及类别患病率。结直肠癌与分期相关的生物学能力由某些非整倍体DI类别体现（超三倍体：无结肠外扩散；亚三倍体：淋巴结转移；三倍体：远处转移）。二倍体与I期以上定义分期的标准无关，且可预测50%发生异时性转移的病例。分期过程中DI类别不规则变化可能归因于二倍体与非整倍体癌不同的肿瘤发生和疾病进展途径。或者，假设非整倍体肿瘤中的二倍体部分包含肿瘤细胞，纯二倍体癌代表一个重要克隆的选择，该克隆可能产生一个进一步的混合群体，其非整倍体DI不同且最适合表达该特定阶段的生物学能力。
