DNA倍体分析对结直肠癌预后的判断价值

Prognostic value of DNA ploidy analysis in patients with colorectal cancer

目的研究DNA倍体异常与结直肠癌预后和生物学特性的关系。方法应用流式细胞术分析82例Ⅱ、Ⅲ期结直肠腺癌癌组织标本的DNA倍性。结果在82例标本中,二倍体36例,占43.9%,异倍体46例,占56.1%。近侧结肠癌的二倍体数目明显多于远侧结肠癌(分别为65.7%和27.7%,P=0.001),DNA倍性与其他临床病理参数无明显相关关系。全组中位随访时间61个月,DNA异倍体肿瘤患者术后总生存率明显低于二倍体患者(P=0.043)。此外,在近侧和Ⅱ期结直肠肿瘤中,均以异倍体组患者的预后为差(分别为P<0.0001;P=0.0005)。结论流式细胞DNA倍性分析有助于阐明结直肠癌的发生机制和生物学特性上的差异,对结直肠癌预后的判断具有重要价值。

Objective To evaluate the relationship between flow cytometric DNA ploidy, biological features and prognosis in patients with stage Ⅱand stage Ⅲcolorectal cancer. Methods Nuclear DNA content was measured by flow cytometry using frozen tumor samples in a prospective series of 82 patients with stage Ⅱand stage Ⅲcolorectal adenocarcinomas receiving curative resection. Results Of 82 samples, 36(43 9%) were diploid and 46(56 1%) were aneuploid. The diploid tumors were significantly more common in the proximal colon than that in the distal colon (65 7%vs.27 7%, P=0 001).There was no correlation between DNA ploidy and clinicopathological variables.Median follow up duration was 61 months. Patients with DNA aneuploid tumors showed a lower overall survival than those with DNA diploid tumors (P=0 043).Furthermore, a poorer prognosis of DNA aneuploid tumors was observed in patients with proximal colon tumors or with stage Ⅱtumors (P< 0 0001, P=0 0005).Conclusion Flow cytometric DNA analysis may explain the difference of colorectal carcinogenesis and biological features between the proximal and distal colorectal cancer and can be used as a prognostic factor in colorectal cancer.