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Evidence of tumor heterogeneity in cervical cancers and lymph node metastases as determined by flow cytometry
Author(s) -
Nguyen Hoa N.,
Sevin BerndUwe,
Averette Hervy E.,
Ramos Reinaldo,
Ganjei Parvin,
Perras James
Publication year - 1993
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(19930415)71:8<2543::aid-cncr2820710818>3.0.co;2-u
Subject(s) - medicine , lymph , lymph node , primary tumor , pathology , tumor heterogeneity , cervical lymph nodes , incidence (geometry) , flow cytometry , stage (stratigraphy) , oncology , metastasis , cancer , biology , immunology , paleontology , physics , optics
Background . The incidence and significance of tumor heterogeneity in primary tumors and metastatic lymph nodes were investigated in Stage IB–IIA cervical cancers. Methods . Paraffin‐embedded tissues from 96 radical hysterectomy specimens were dewaxed, disaggregated, and subjected to dual parameter flow cytometry. Threedimensional histograms were generated to delineate different tumor populations. A DNA index difference of at least ± 0.15 was used to define tumor heterogeneity. Results . Mean DNA index difference of various tumor populations was 0.29 ± 0.13. Among 69 patients with normal lymph nodes, there were 12 patients (incidence, 17.4%) with tumor heterogeneity in the primary tumors. Of 27 patients with metastatic lymph nodes, 5 (incidence, 18.5%) had evidence of tumor heterogeneity in the primary tumor, and 18 of 47 (incidence, 38.3%) had tumor heterogeneity in metastatic lymph nodes. When using DNA index to determine clonal origin of metastatic lymph nodes, as many as 60% of the metastases could not be traced to the primary tumor. Tumor heterogeneity was associated with a 40% reduction in median survival time. However, because of the small number of patients with tumor heterogeneity, statistical analyses did not show prognostic significance. Conclusions . Tumor heterogeneity appeared to be a common characteristic of early cervical carcinoma. Additional study is needed to fully evaluate its prognostic value.