Flow Cytometry of Ovarian Neoplasms

Abstract

Epithelial carcinomas are the most common malignant tumors of the ovary and are the most common cause of death from genital malignancies in women (Ball et al. 1990). Although advances in therapy have resulted in prolonged disease-free survivals, these intensive treatments are associated with substantial side-effects and the majority of women with advanced stage epithelial carcinoma eventually die of their tumor despite therapy. These factors have resulted in a search for features that would permit greater prognostic accuracy and tailoring of treatment regimens to the biologic behavior of the tumor in an individual patient. The development of a method of DNA analysis on paraffin-embedded tissue by Hedley and co-workers (Hedley et al. 1983, 1985; Hedley 1989) has prompted numerous investigations of the prognostic significance of DNA content and cell cycle analysis as possibly more objective and reproducible indicators of tumor behavior. The majority of these studies have examined the relation of flow cytometric analysis to known prognostic factors and to survival in surface epithelial carcinomas; a smaller number of studies have addressed these issues in ovarian neoplasms of other types. This article will briefly summarize the technical aspects of DNA analysis by flow cytometry, concentrating on technical difficulties that may interfere with the analysis, and then review in detail the relation of DNA ploidy and cell cycle data to clinical and histologic features and survival for each tumor type.