DNA flow cytometry in stage IB and II cervical carcinoma

Abstract

In a retrospective study the prognostic significance of nuclear DNA content was investigated, as measured by flow cytometry, of the tumor specimens from 212 women with nonpretreated FIGO stage IB and II cervical cancer. One‐hundred and thirty cases (62%) were found to be diploid, whereas 82 (38%) were aneuploid. Univariate analysis of the follow‐up data showed an increased relative risk (RR) for recurrence free survival (RFS) for stage II tumors (RR = 1.87, 95% CI: 1.13–3.10, P = 0.015) and for age (RR = 1.52, 95% CI: 0.66–3.52 and RR = 2.35, 95% CI: 1.19–4.65, P = 0.032). Ploidy showed a relative risk of 1.33 (95% CI: 0.83–2.13, NS). In addition, univariate analysis of overall survival (OS) revealed similar results. For the subgroup of patients with primary surgery (n = 151), positive pelvic nodes (RR = 5.38, 95% CI: 2.70–10.71, P = 0.0001) and parametrial extension (RR = 2.53, 95% CI: 1.24–5.17, P = 0.011) were significant factors for OS after univariate analysis, the estimated effects on RFS were slightly smaller. Multivariate analysis of RFS for the whole study population showed age, histologic grade and stage with a slightly increased risk, but no effect was significant. Ploidy with an RR of 0.97 (95% CI: 0.58–1.62) seems to have no influence on prognosis. For the subgroup with primary surgery, ploidy again failed statistical significance with an RR of 1.20 (95% CI: 0.58–2.49). Our results suggest that abnormalities of the nuclear DNA content in this homogeneous group of patients are associated with clinical and morphological prognosticators, however, ploidy is not an independent prognostic factor for RFS, or for the whole study population or for the subgroup with primary surgery.

Ploidy in gynaecological cancers

“…A high proportion of invasive cervical neoplasms show DNA aneuploidy 3 but attempts to demonstrate that aneuploid carcinomas have a worse prognosis than diploid ones have, with relatively few exceptions, 123–125 either proved wholly unsuccessful or have yielded equivocal, and usually not statistically significant, results, 106,126–141 this applying equally to squamous and glandular carcinomas. Studies of ploidy as a prognostic factor for responsiveness of cervical carcinomas to radiotherapy have yielded contradictory results, 142,143 whilst ploidy does not serve as a good predictor of response to adjuvant chemotherapy 144 …”

Clinical value of new techniques of gynecological tumor assessment

“…A high proportion of invasive cervical carcinomas show DNA aneuploidy(1), but attempts to show that in cervical neoplasiaaneuploid tumors have a worse prognosis thandiploid neoplasms have either proved wholly unsuccessful or have yieldedequivocal and usually not statistically significant results(35–42).…”