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Flow cytometric DNA analysis of cirrhotic liver cells in patients with hepatocellular carcinoma can provide a new prognostic factor
Author(s) -
Ruà Savino,
Comino Alberto,
Fruttero Adriana,
Torchio Pierfederico,
Bouzari Hedayat,
Taraglio Stefano,
Torchio Bruno,
Capussotti Lorenzo
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19960915)78:6<1195::aid-cncr5>3.0.co;2-9
Subject(s) - hepatocellular carcinoma , medicine , cirrhosis , flow cytometry , pathology , proportional hazards model , univariate analysis , gastroenterology , carcinoma , survival analysis , cancer research , oncology , multivariate analysis , immunology
BACKGROUND DNA flow cytometry of hepatocellular carcinoma (HCC) cells has been investigated in many studies, but, to the best of our knowledge, there are no data on DNA analysis of cirrhotic parenchyma around the HCC. In this study, cell kinetics and ploidy of parenchymal cells around HCC were performed to ascertain if this would predict the possibility of recurrence in the cirrhotic areas. METHODS The DNA content of 93 cases of HCC and of cirrhotic liver around the tumor nodules was analyzed by flow cytometry. Ploidy and proliferative index of HCC and cirrhotic liver were compared with macroscopic, histologic, and clinical features of each case and linked with the behavior of these tumors. Survival curves were assessed according to the Kaplan‐Meier method. A multivariate analysis based on Cox proportional hazards regression model was performed on cases of diploid cirrhosis cells in which the S‐phase fraction was evaluable. RESULTS The univariate analysis of survival suggested significant roles for age, number of intrahepatic nodules, Edmondson‐Steiner's classification, portal invasion, vascular invasion, presence of necrosis, hepatitis B surface antigen, α‐fetoprotein, Child's score, ploidy, and S‐phase fraction of HCC cells. The DNA analysis of the cirrhotic cells showed that polyploidy was dramatically reduced in patients with HCC, compared with normal hepatocytes, and aneuploid clones were present among diploid cells. High S‐phase fraction of cirrhotic cells and Child‐Pugh classification were the strongest independent parameters affecting the tumor behavior in this study. CONCLUSIONS The results of this study suggest that S‐phase fraction of cirrhotic liver parenchyma may be employed as a new parameter in the prognostic evaluation of HCC patients. Cancer 1996;78:1195‐1202.