Reles A E, Gee C, Schellschmidt I, Schmider A, Unger M, Friedmann W, Lichtenegger W, Press M F
Virchow-Klinikum, Humboldt University, Berlin, 13347, Germany.
Gynecol Oncol. 1998 Oct;71(1):3-13. doi: 10.1006/gyno.1998.5156.
The objective of this study was to evaluate the prognostic significance of DNA ploidy and S-phase fraction (SPF) in epithelial ovarian carcinomas analyzed by image cytometry. Frozen tissue of 103 epithelial ovarian carcinomas was analyzed for DNA ploidy and SPF with a Cell Analysis System Image Analyser (CAS 200, Becton-Dickinson) and correlations with clinical and histomorphologic factors and time to progression and overall survival were evaluated by univariate and multivariable analysis. Fifty-four percent of the ovarian carcinomas were found to be diploid, 38% aneuploid, and 8% tetraploid. The S-phase fraction was low (<5%) in 27%, intermediate (5-14.5%) in 47%, and high (>/=14.5%) in 26% of the patients. By univariate analysis overall survival and time to progression were significantly correlated with the S-phase fraction (P = 0.003 and P = 0.003), but not with DNA ploidy (P = 0. 31 and P = 0.51). A DNA index > 1.4 was correlated with poor outcome but the result did not achieve formal statistical significance (P = 0.08 and P = 0.12). A high SPF was a strong predictor of early recurrence, while a low SPF identified patients with a favorable long-term outcome. Other significant predictors of survival were FIGO stage, grade of differentiation, presence of distant metastasis, residual tumor, lymph node metastasis, and patient age. In multivariable statistical analysis only FIGO stage, histologic grade, and residual tumor after surgery were independent predictors of overall survival and time to progression.
本研究的目的是通过图像细胞术评估DNA倍体和S期分数（SPF）在上皮性卵巢癌中的预后意义。使用细胞分析系统图像分析仪（CAS 200，Becton-Dickinson）对103例上皮性卵巢癌的冷冻组织进行DNA倍体和SPF分析，并通过单变量和多变量分析评估其与临床和组织形态学因素以及进展时间和总生存的相关性。发现54%的卵巢癌为二倍体，38%为非整倍体，8%为四倍体。27%的患者S期分数低（<5%），47%的患者为中等（5 - 14.5%），26%的患者高（≥14.5%）。通过单变量分析，总生存和进展时间与S期分数显著相关（P = 0.003和P = 0.003），但与DNA倍体无关（P = 0.31和P = 0.51）。DNA指数>1.4与不良预后相关，但结果未达到正式统计学显著性（P = 0.08和P = 0.12）。高SPF是早期复发的有力预测指标，而低SPF则表明患者长期预后良好。生存的其他重要预测指标包括国际妇产科联盟（FIGO）分期、分化程度、远处转移的存在、残留肿瘤、淋巴结转移和患者年龄。在多变量统计分析中，只有FIGO分期、组织学分级和手术后残留肿瘤是总生存和进展时间的独立预测指标。
