The DNA index is a strong predictive marker in intrahepatic cholangiocarcinoma: the results of a five-year prospective study
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Predictive markers for risk stratification among patients with intrahepatic cholangiocarcinoma (IHC) are still lacking. Therefore, recent studies have focused on identifying the biological aspects of tumors that can provide more information about the tumor aggressiveness. The aim of this study was to prospectively evaluate the prognostic potential of the DNA index in patients undergoing liver resection for IHC.
In a prospective long-term follow-up study, the DNA index of 65 IHC patients undergoing liver resection was assessed by DNA image cytometry, and this parameter, as well as standard histopathological parameters, correlated with the patient survival.
The mean DNA index was 1.69 ± 0.66 (range, 0.9–4.3). The univariate survival analysis showed that the DNA index (p = 0.024) and tumor stage (p = 0.017) were associated with patient survival, whereas all other standard histopathological factors had no predictive value. The multivariate analysis identified the DNA index (p = 0.050) and tumor stage (p = 0.028) as independent prognostic parameters.
The DNA index is an independent predictive marker for IHC after liver resection. It is superior to most standard histopathological parameters and can be assessed pre- and postoperatively. Therefore, the DNA index might represent a promising tool in the decision-making process for patients with IHC.
- Khan SA, Taylor-Robinson SD, Toledano MB, Beck A, Elliott P, Thomas HC. Changing international trends in mortality rates for liver, biliary and pancreatic tumours. J Hepatol. 2002;37(6):806–13. CrossRef
- Patel T. Increasing incidence and mortality of primary intrahepatic cholangiocarcinoma in the United States. Hepatology. 2001;33(6):1353–7. CrossRef
- Shaib YH, Davila JA, McGlynn K, El-Serag HB. Rising incidence of intrahepatic cholangiocarcinoma in the United States: a true increase? J Hepatol. 2004;40(3):472–7. CrossRef
- Endo I, Gonen M, Yopp AC, Dalal KM, Zhou Q, Klimstra D, et al. Intrahepatic cholangiocarcinoma: rising frequency, improved survival, and determinants of outcome after resection. Ann Surg. 2008;248(1):84–96. CrossRef
- Guglielmi A, Ruzzenente A, Campagnaro T, Pachera S, Valdegamberi A, Nicoli P, et al. Intrahepatic cholangiocarcinoma: prognostic factors after surgical resection. World J Surg. 2009;33(6):1247–54. CrossRef
- Murakami Y, Uemura K, Sudo T, Hashimoto Y, Nakashima A, Kondo N, et al. Prognostic factors after surgical resection for intrahepatic, hilar, and distal cholangiocarcinoma. Ann Surg Oncol. 2011;18(3):651–8. CrossRef
- Konstadoulakis MM, Roayaie S, Gomatos IP, Labow D, Fiel MI, Miller CM, et al. Fifteen-year, single-center experience with the surgical management of intrahepatic cholangiocarcinoma: operative results and long-term outcome. Surgery. 2008;143(3):366–74. CrossRef
- Saxena A, Chua TC, Sarkar A, Chu F, Morris DL. Clinicopathologic and treatment-related factors influencing recurrence and survival after hepatic resection of intrahepatic cholangiocarcinoma: a 19-year experience from an established Australian hepatobiliary unit. J Gastrointest Surg. 2010;14(7):1128–38. CrossRef
- DeOliveira ML, Cunningham SC, Cameron JL, Kamangar F, Winter JM, Lillemoe KD, et al. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg. 2007;245(5):755–62. CrossRef
- Bergquist A, Tribukait B, Glaumann H, Broome U. Can DNA cytometry be used for evaluation of malignancy and premalignancy in bile duct strictures in primary sclerosing cholangitis? J Hepatol. 2000;33(6):873–7. CrossRef
- Abou-Rebyeh H, Al-Abadi H, Jonas S, Rotter I, Bechstein WO, Neuhaus P. DNA analysis of cholangiocarcinoma cells: prognostic and clinical importance. Cancer Detect Prev. 2002;26(4):313–9. CrossRef
- Iachino C, Catsicojannis N, Dallera F. Prognostic significance of tumor DNA content in carcinoma of the hepatic duct confluence. J Exp Clin Cancer Res. 1998;17(4):425–30.
- Weger AR, Graf AH, Askensten U, Schwab G, Bodner E, Auer G, et al. Ploidy as prognostic determinant in pancreatic cancer. Lancet. 1987;2(8566):1031. CrossRef
- Lanza G, Gafa R, Santini A, Maestri I, Dubini A, Gilli G, et al. Prognostic significance of DNA ploidy in patients with stage II and stage III colon carcinoma: a prospective flow cytometric study. Cancer. 1998;82(1):49–59. CrossRef
- Sato Y, van Gulik TM, Bosma A, Lygdiakis NJ, Koyama K, van der Heyde MN. Prognostic significance of tumor DNA content in carcinoma of the hepatic duct confluence. Surgery. 1994;115(4):488–94.
- Rijken AM, Umezawa A, van Gulik TM, Bosma A, Pollak MM, Offerhaus GJ, et al. Prognostic value of cell proliferation (Ki-67 antigen) and nuclear DNA content in clinically resectable, distal bile duct carcinoma. Ann Surg Oncol. 1998;5(8):699–705. CrossRef
- Hedley DW, Friedlander ML, Taylor IW. Application of DNA flow cytometry to paraffin-embedded archival material for the study of aneuploidy and its clinical significance. Cytometry. 1985;6(4):327–33. CrossRef
- Chatelain R, Willms A, Biesterfeld S, Auffermann W, Böcking A. Automated Feulgen staining with a temperature-controlled staining machine. Anal Quant Cytol Histol. 1989;11(3):211–7.
- Bocking A, Giroud F, Reith A. Consensus report of the ESACP task force on standardization of diagnostic DNA image cytometry. European Society for Analytical Cellular Pathology. Anal Cell Pathol. 1995;8(1):67–74.
- Morine Y, Shimada M, Utsunomiya T, Imura S, Ikemoto T, Mori H, et al. Clinical impact of lymph node dissection in surgery for peripheral-type intrahepatic cholangiocarcinoma. Surg Today. 2012;42(2):147–51. CrossRef
- Muenphon K, Limpaiboon T, Jearanaikoon P, Pairojkul C, Sripa B, Bhudhisawasdi V. Amplification of chromosome 21q22.3 harboring trefoil factor family genes in liver fluke related cholangiocarcinoma is associated with poor prognosis. World J Gastroenterol. 2006;12(26):4143–8.
- Kawaki J, Miyazaki M, Ito H, Nakagawa K, Shimizu H, Yoshidome H, et al. Allelic loss in human intrahepatic cholangiocarcinoma: correlation between chromosome 8p22 and tumor progression. Int J Cancer. 2000;88(2):228–31. CrossRef
- Pradhan M, Abeler VM, Danielsen HE, Sandstad B, Tropé CG, Kristensen GB, et al. Prognostic importance of DNA ploidy and DNA index in stage I and II endometrioid adenocarcinoma of the endometrium. Ann Oncol. 2012;23(5):1178–84. CrossRef
- Jonas S, Al-Abadi H, Benckert C, Thelen A, Hippler-Benscheid M, Saribeyoglu K, et al. Prognostic significance of the DNA-index in liver transplantation for hepatocellular carcinoma in cirrhosis. Ann Surg. 2009;250(6):1008–13. CrossRef
- The DNA index is a strong predictive marker in intrahepatic cholangiocarcinoma: the results of a five-year prospective study
Volume 44, Issue 7 , pp 1336-1342
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- DNA ploidy
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- 1. Department of General Visceral and Transplantation Surgery, Charité University Hospital, Berlin, Germany
- 4. Department of General Visceral and Transplantation Surgery, Charité, University Medicine, Campus Virchow Clinic, Augustenburger Platz 1, 13353, Berlin, Germany
- 2. Institute of Pathology, Charité University Hospital, Berlin, Germany
- 3. Institute of Pathology, University Hospital, Heidelberg, Germany