Flow cytometric DNA analysis in gynecological oncology

Abstract

The relevance of flow cytometric DNA analysis in neoplasia of the female genital tract is reviewed. The virtues and limitations of the technique are discussed. There is good evidence, mainly from retrospective studies, that DNA ploidy and/or the tumor S-phase fraction are valuable prognostic indicators in patients with carcinoma of the ovary and endometrium. Further prospective studies are needed, however, to establish the precise value of flow cytometric DNA analysis before it can be used safely for stratification of therapeutic regimes.

Ploidy in gynaecological cancers

“…However, the technique has well‐known pitfalls and difficulties and can detect DNA aneuploidy only if a significant proportion of the tumour cells have lost or duplicated several chromosomes 3,4 . Other variables that have to be taken into consideration are the method of extraction and staining of the nuclei, delays in tissue fixation, intra‐ and interlaboratory variability, the minimum number and proportion of tumour cells analysed, the choice of the reference cell population, the programme for debris correction and, very importantly, tumour heterogeneity 3–12 . Furthermore, the interpretation of DNA histograms is not always straightforward, for there is a grey area between DNA diploidy and DNA aneuploidy and it can be difficult to define what constitutes a true diploid histogram and when aneuploidy begins.…”

Multiparameter flow cytometric measurement of epidermal growth factor receptor and c-erbB-2 oncoprotein in cultured cells and in fresh and preserved solid tumor cells

“…Progress in defining a role for this technique in the assessment of solid tumors has been slow, partly because of the far greater histologic complexity of solid tissues and partly because of practical difficulties in obtaining suitable monocellular suspensions for study. Over the past decade great advances have been made, and flow cytometry is now widely used for the measurement of DNA in solid tumors (1). Recently, possible uses of the technique have expanded with the development of flow cytometric assays to measure other cellular components (2)(3)(4).…”

DNA Ploidy is Stronger Than Lymph Node Metastasis as Prognostic Factor in Cervical Carcinoma: 10-Year Results of a Prospective Study

“…7 In the literature, we found a large agreement about the prognostic value of ploidy and SPF concerning ovarian and endometrial cancer. 1 Results about the prognostic significance of ploidy in cervical cancer, instead, are contradictory. Some authors support the independent effect that DNA ploidy plays on survival: Jakobsen 3 in 1984 reported high frequency of lymph node metastasis and relapses in early stage aneuploid cervical carcinomas and this data was independent of radiant or surgical treatment.…”