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Flow cytometric DNA index in the prognosis of colorectal cancer
Author(s) -
Giaretti Walter,
Danova Marco,
Geido Elio,
Mazzini Giuliano,
Sciallero Stefania,
Aste Hugo,
Scivetti Paolo,
Riccardi Alberto,
Marsano Barbara,
Merlo Franco,
D'Amore Emanuele S. G.
Publication year - 1991
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19910401)67:7<1921::aid-cncr2820670717>3.0.co;2-x
Subject(s) - relative risk , medicine , cancer , stage (stratigraphy) , colorectal cancer , aneuploidy , pathology , dna , incidence (geometry) , gastroenterology , oncology , biology , confidence interval , gene , chromosome , genetics , paleontology , physics , optics
Abstract The authors investigated the relationship between flow cytometric DNA index (DI, defined as the ratio of the DNA content of malignant cells to that of normal cells) and other prognostic factors (grade and stage, anatomical site, age and sex) with the survival of 115 patients with colorectal cancer. Multiple biopsy specimens from 62 patients were taken during colonoscopy before surgery. Additional samples from 53 patients were obtained from paraffin‐embedded material. All patients were treated with surgery only. Fresh–frozen material gave higher incidence of DNA aneuploidy than paraffin‐embedded material (79% versus 41%). The patients with DNA diploid tumors (DI = 1) had a better overall survival than those with DNA aneuploid tumors (DI > 1). Among DNA aneuploid tumors, those with DI > 1.2 (excluding DI = 2) were worse than those with DI > 1.2 (excluding DI = 1) and DI = 2. Cox's regression analysis showed that pathologic stage was more important for prognosis than DNA index, whereas age, sex, histologic grade, and anatomic site were removed from the analysis as not relevant for prognosis. Relative risks of death (RR), in reference to patients with DI = 1 and Stages A + B (RR = 1), were RR = 1.8 for patients with carcinomas with Stage C, RR = 2.7 for patients with carcinomas with DNA near‐diploid and DNA tetraploid tumors, RR = 3.5 for those with DI > 1.2 (excluding DI = 2), and RR = 8.0 for those with Stage D. These data indicate that flow cytometrically evaluated DI values have a relevant independent power for predicting the clinical outcome of colorectal cancer patients.