Flow Cytometric DNA Analysis of Stage D2 Prostatic Carcinoma

Yokogi, Hiroyuki; Mizutani, Masami; Ishibe, Tomoyuki

doi:10.1159/000282186

Cited by 7 publications

(4 citation statements)

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“…Si bien se ha establecido la influencia de la ploidía en los tumores tratados hormonalmente 25,26 , no se ha definido definitivamente su valor pronóstico y aunque hay estudios que indican que la ploidía del tumor primario carece de importancia pronóstica cuando existen metástasis esqueléticas 22,27,28 , otros, al igual que el nuestro, señalan cierta influencia. Así Miller y cols.…”

Section: Discussionunclassified

Valor pronóstico de la ploidía del ADN y la morfometría nuclear en el cáncer de próstata metastásico

Jabaloyas¹,

Sánchez²,

Cerdá³

et al. 2004

Actas Urol Esp

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Conocer el valor pronóstico de la ploidía del ADN y la morfometría nuclear determinadas en el foco tumoral primario en pacientes afectos de cáncer de próstata con metástasis óseas. MÉTODOS: Estudio retrospectivo sobre 54 pacientes con adenocarcinoma de próstata y metástasis óseas tratados con supresión androgénica. En todos ellos se realizó análisis de ADN (citometría de flujo) sobre tejido tumoral desparafinado y estudio de morfometría nuclear. También se analizó la edad, la puntuación de Gleason, la categoría T, el hematocrito, el nivel de albúmina sanguínea, las fosfatasas alcalinas, fosfatasas ácidas prostáticas, y el número de focos metastásicos que aparecían en el rastreo. Se realizaron estudios univariantes y multivariantes de supervivencia mediante el método de Kaplan-Meier y de riesgos proporcionales de Cox, respectivamente. Finalmente, realizamos un análisis de regresión logística multivariante para los factores pronósticos clásicos y otro en el que se añadieron los experimentales (ploidía de ADN y morfometría nuclear), con la intención de conocer qué factores pueden predecir el que un paciente alcance la mediana de supervivencia y en qué medida los factores experimentales mejoran dicha predicción. RESULTADOS: En el análisis univariante de supervivencia tuvieron carácter pronóstico la categoría T, el nivel de albúmina, las fosfatasas alcalinas, la puntuación de Gleason, el rastreo óseo, la ploidía del ADN y el área nuclear media. En el multivariante únicamente aportaron información pronóstica independiente la puntuación de Gleason, el rastreo óseo, el área nuclear media y la ploidía del ADN. En el estudio de regresión logística para factores pronósticos clásicos únicamente el Gleason tiene capacidad predictiva (sensibilidad 89,3%, especificidad 64%), mientras que al introducir los factores experimentales también el rastreo óseo y la ploidía del ADN son significativos (sensibilidad 90% y especificidad 72%). CONCLUSIONES: El estudio de contenido de ADN y de morfometría nuclear del foco tumoral primitivo aporta información pronóstica independiente en el análisis de supervivencia para el cáncer de próstata metastásico. Sin embargo, la escasa mejora en la capacidad predictiva sobre los factores pronósticos clásicos cuestionan su utilidad en la práctica clínica. PALABRAS CLAVE: Cáncer de próstata. Metástasis. Ploidía del AND. Núcleo celular. Factores pronósticos. Análisis multivariante.

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Section: Discussionunclassified

Valor pronóstico de la ploidía del ADN y la morfometría nuclear en el cáncer de próstata metastásico

Jabaloyas¹,

Sánchez²,

Cerdá³

et al. 2004

Actas Urol Esp

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“…With regard to patients with distant metastases, no studies reporting multivariate analysis, including DNA content, could be found. Miller et al (1991) performed a univariate and chi-square analysis including tumor grade and observed additional prognostic information given by the DNA content in both analyses, while in 2 other reports (Hedlund et al, 1991;Yokogi et al, 1991) no prognostic value of measuring DNA content could be found in univariate analyses. The data regarding patients with metastasized disease are conflicting.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of deoxyribonucleic acid content in prostate cancer: A review of current results

Adolfsson

1994

Intl Journal of Cancer

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A total of 115 articles on prostate cancer were reviewed for data on the prognostic value of DNA content in the tumor cells. In 44 series, data pertinent to this review were found. There was no consensus in the literature with respect to methods of analysis of DNA content or definitions of subclasses of DNA content such as categories of ploidy. The DNA content of prostate cancer cells was strongly related to tumor grade and stage. When analyzed as a single parameter in univariate analyses, the DNA content had a prognostic value with respect to overall or disease-specific survival. In multivariate analyses the additional prognostic value of the DNA content was less convincing when analysed with tumor grade and stage. The prognostic data from univariate and multivariate analyses available in the literature were mainly derived from patients with advanced disease and data on localized, potentially curable disease were scanty and conflicting.

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“…• 32 revealed an inadequate study design: 10 comprised < 50 patients [54][55][56][57][58][59][60][61][62][63], 6 had a mixture of different types of therapy [64][65][66][67][68][69], 5 missed sufficient therapeutic information [70][71][72][73][74], 3 missed sufficient follow-up information [75][76][77], 4 applied an inadequate gold standard (digital rectal examination, cancer volume) [78][79][80][81], 2 selected prognostically extreme groups of patients [82,83], 1 comprised mixed tumor-stages [84], 1 presented no details on recurrence [85].…”

Section: Excluded Papersmentioning

confidence: 99%

DNA-cytometric grading of prostate cancer Systematic review with descriptive data analysis

Böcking¹,

Tils²,

Schramm³

et al. 2014

Pathol Discov

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Gleason-score <=6, assessed on core needle biopsies, is an essential prognostic parameter to offer the strategy of Active Surveillance (AS) to patients with locally confined cancers of the prostate. Yet, its interobserver reproducibility is low (48-70%) and its prognostic validity unsatisfactory. An option to complementary assess the malignant potential of these cancers are objective DNA-ploidy-measurements on existing biopsies. For that purpose chromosomal heterogeneity is indirectly quantified by DNA-cytometry resulting in DNA-grades of malignancy 1-4. This review systematically trawls and evaluates all scientific publications on the potential diagnostic and prognostic validity and the heterogeneity of DNA-ploidy measurements in cancers of the prostate between 1966 and 2013. Publications have been classified into Oxford levels of evidence and levels of significance were given for the correlation of DNA-ploidy with different clinical outcomes. 114 scientific articles had to be excluded because of different methodological reasons. All but one of the 67 methodologically acceptable articles report on a significant diagnostic resp. prognostic significance of DNA ploidy measurements in cancers of the prostate. 8 level 1b studies report that DNA-ploidy, assessed on punch biopsies independently predicts organ confinement as assessed after radical prostatectomy. 18 level 2b studies prove that DNA-ploidy measurements add statistically significant information to the Gleason-score. 16 level 2b investigations report a significant correlation of DNA-ploidy with recurrence-free survival. 15 level 2b studies document a significant correlation with overall survival after different types of therapy. 5 level 2b investigations prove a significant correlation with local recurrence or progress after radical prostatectomy. 3 level 2b publications show a significant correlation of DNAploidy with the occurrence of lymph node-or bone metastases after radical prostatectomy. 1 level 2b study documents the additional prognostic value of DNA-ploidy measurements over conventional subjective grading in prostate cancer patients under AS. All existing 15 narrative reviews on selected articles dealing with prognostic DNA-cytometry in cancers of the prostate are in favor of this method. Prospective level 1b studies, especially those proving the validity of DNA ploidy measurements to predict non-progression in patients with clinically insignificant low-grade low stage cancers of the prostate eligible for Active Surveillance additionally to the Gleason-score are still missing.

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Flow Cytometric DNA Analysis of Stage D2 Prostatic Carcinoma

Cited by 7 publications

References 0 publications

Valor pronóstico de la ploidía del ADN y la morfometría nuclear en el cáncer de próstata metastásico

Valor pronóstico de la ploidía del ADN y la morfometría nuclear en el cáncer de próstata metastásico

Prognostic value of deoxyribonucleic acid content in prostate cancer: A review of current results

DNA-cytometric grading of prostate cancer Systematic review with descriptive data analysis

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