Background. The prognostic significance of tumor DNA ploidy in patients with cancer of the pancreas has not been defined because conflicting results have been reported. Methods. DNA content was measured in 56 ductal adenocarcinomas of the pancreas. DNA ploidy status was evaluated by flow cytometry in nuclei isolated from paraffin‐embedded tumor tissues. Results. An abnormal DNA stemline was observed in 27 (48%) patients. The percentage of aneuploid tumors was significantly increased in tumors classified as Stage III/IV (53%) compared with those classified as Stage I (22%). A borderline significant association existed between DNA ploidy and radicality of surgery (P = 0.08). The median survival of patients with diploid carcinomas was 6.9 months (standard error, ±0.9) in comparison to 4.5 ± 1.2 months for patients with aneuploid tumors (P = 0.013 by generalized Wilcoxon test; P = 0.023 by generalized Savage test). Although a selection bias cannot be excluded, survival of patients with a radical resection was longer than that of patients with a nonradical resection (P = 0.0008 and P = 0.0085, respectively). In addition, presence of distant metastasis (P = 0.0006 [Wilcoxon test] and P = 0.033 [Savage test]) could be identified as a prognostic factor. In a Cox regression model, results of surgery and DNA ploidy were independent prognostic variables. Conclusions. Because DNA ploidy has a significant impact on prognosis in pancreatic cancer, it should be used as a variable for stratified randomization of patients in therapeutic trials.
The influence of preoperative radiotherapy on the prevalence of DNA aneuploidy and the prognostic significance of tumour DNA ploidy was evaluated in 126 patients with squamous cell carcinoma of the oesophagus. Preoperative radiotherapy with 30 A nuclear suspension was prepared by incubating the sections in 0-5% pepsin (Sigma, St Louis, Missouri) in 0 9% NaCl solution (pH 1-5; 37°C). After filtration through a 50 [im nylon mesh nuclei were washed twice with phosphate buffered saline. The sediment was resuspended in a 041% Nonidet P 40 -trisodium citrate solution.7 After addition of ribonuclease A (Sigma, St Louis, Missouri; final concentration 041%) nuclear DNA was stained with propidium iodide (Sigma, St Louis, Missouri; 50 Fg/ml).
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