Flow cytometric studies of ploidy and proliferative indices in the Yorkshire trial of adjuvant progestogen treatment of endometrial cancer

Abstract

Objective To estimate whether flow cytometric indices provide independent measures of prognosis or predict response to prophylactic progestogens in endometrial cancer. Design Endometrial tumour specimens were retrieved and analysed by flow cytometry from 257 women who had been randomly allocated in a previous trial to receive prophylactic progestogen in addition to conventional therapy for endometrial carcinoma. Setting Fourteen district and two teaching hospitals in West Yorkshire. Subjects Women developing primary endometrial cancer between 1975 and 1983. Main outcome measures Tumour ploidy status and proliferative indices and the relation of these to tumour stage and grade, to prognosis and to response to progestogens. Results Ploidy status and proliferative indices were related to tumour stage, grade and patient survival but were not independent predictors of survival. They did not predict patients who would respond to progestogens although there was a nonsignificant trend towards patients with diploid tumours surviving longer after progestogen treatment. Conclusions Flow cytometry adds little to established prognostic indicators for endometrial cancer.

Proliferative activity as revealed by Ki‐67 in uterine adenocarcinoma of endometrioid type: Comparison of tumours from patients with and without previous oestrogen therapy

“…higher S-phase fraction in poorly differentiated carcinomas even though the correlation to BrDU was very weak.4 However, in another study no independent predictive value with regard to survival was found when S-phase was corrected for stage and histological grade. 18 The significant difference in Ki-67 expression in tumours from patients with postmenopausal oestrogen therapy compared with tumours from patients who have never received oestrogen treatment supports the belief that tumours from the two groups of patients are of different biology. (It is worth noting that the counting of mitotic figures discriminates the two groups of patients to a much smaller degree than Ki-67.…”

Molecular pathogenesis and prognostic factors in endometrial carcinoma

“…Chromosomal instability leading to structural or numerical aberrations is recognized as an early feature of malignant transformation. These changes occur with high frequency in various malignancies, including endometrial carcinomas, where aneuploidy has been reported in about 20–35% (135, 157, 158). Among endometrial carcinoma patients, measures of DNA ploidy have been found to be significantly correlated with established prognostic factors (159–161).…”

Renovated (nondual) approach to endometrial cancer typing: endocrine and inflammatory issues

“…In conclusion, we should be reminded that currently nearly forgotten EC adjuvant therapy with progestins was widely used 30-35 years ago [25]. This change in therapeutic approach may have promoted the switch of certain patient populations to apparently justified but harsher treatment regimens.…”