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DNA ploidy and biologic aggressiveness of gastric adenocarcinoma in Chinese

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Abstract

The mortality rate of gastric cancer in the Chinese population has reached a plateau. The main prognostic factor for gastric adenocarcinoma is recognized as tumor stage. Recently, abnormalities in DNA content have been considered as a new prognostic factor. Whether abnormal DNA content can be used as a prognostic tool for Chinese patients with gastric cancer is unknown. To investigate this relation DNA ploidy and prognosis of gastric cancer patients were studied using paraffin-embedded specimens. A group of 104 newly diagnosed and surgically resected gastric cancer specimens obtained from January 1984 to December 1986 were examined for DNA content by flow cytometry. The quality of flow cytometry was acceptable with a mean coefficient of variance of 5.45. The results showed that 38 cases (36.5%) had DNA aneuploidy; 42 cases had metastatic lymph nodes with enough tumor cells, and 31.0% of these cases had DNA aneuploidy. DNA aneuploidy of primary tumors was correlated to lymph node metastasis and patient's age, whereas DNA aneuploidy of metastatic lymph nodes was significantly correlated to the serosal invasion of the gastric wall at the primary site. The important parameters for prognosis were curability of surgical resection, serosal invasion, tumor size, and distant metastasis. DNA aneuploidy of both primary tumors or metastatic lymph nodes appeared to be unrelated to the prognosis of gastric adenocarcinoma in Chinese patients. We therefore propose that DNA aneuploidy of gastric cancer is associated with tumor growth but not biologic aggressiveness.

Résumé

La mortalité en rapport avec le cancer gastrique en Chine a atteint un plateau. Le facteur pronostique majeur reconnu par tous est le stade tumoral. Récemment, les anomalies de l'ADN ont été proposées comme un facteur pronostique nouveau. Que l'ADN puisse être utilisé comme un facteur pronostique dans la population chinoise n'est pas connu. Pour examiner ce problème, la ploïdie ADN a été étudiée sur des préparations de paraffine et comparée au pronostic des patients ayant un cancer gastrique. Cent quatre pièces de gastrectomie réséqués chirurgicalement entre Janvier 1984 et Décembre 1986 ont été exammés pour leur contenu en ADN par la cytométrie de flux. La qualité de cytométrie de flux a été acceptable avec un coefficient de variance moyen de 5.45. Les résultats ont montré que trente-huit cas (36.5%) avaient une aneuploïdie d'ADN. Dans 42 cas, les ganglions métastatiques contenaient suffisamment de cellules malignes dont 31% avaient une aneuploïdie d'ADN. L'aneuploïdie d'ADN des tumeurs primitives était corrélé avec les métastases ganglionnaires et l'âge, alors que l'aneuploïdie des ganglions métastatiques était corrélé de façon significative avec l'invasion de la séreuse au niveau de la tumeur. Les paramètres importants du pronostic étaient la curabilité par la résection chirurgicale, l'invasion de la séreuse, la taille de la tumeur et l'existence de métastases à distance. Cepencant, l'aneuploïdie d'ADN des tumeurs primitives comme celle des ganglions métastatiques ne paraît pas être corrélée avec le pronostic des cancers gastriques de la population chinoise. Nous suggérons que l'aneuploïdie des cancers gastriques est lié a la croissance tumorale mais pas à l'agressivité biologique.

Resumen

La tasa de mortalidad del cáncer gástrico en la población china ha llegado a un “plateau”. Se reconoce que el principal factor de pronóstico en el adenocarcinoma gástrico es el estado del tumor, pero recientemente se considera que las anormalidades en el contenido del DNA nuclear constituyen un nuevo factor de pronóstico. Sin embargo, no se sabe si tales anormalidades en el contenido de DNA pueden ser utilizadas como un elementos de pronóstico en pacientes chinos con cáncer gástrico. Con el objeto de investigar esta relación de la ploidia de DNA con el pronóstico, se estudiaron especímenes incluidos en parafina. Ciento cuatro especímenes de resección gástrica obtenidos ente enero de 1984 y diciembre de 1987 fueron examinados para contenido de DNA mediante citometría de flujo. La calidad de la citometría de flujo apareció aceptable, con un coeficiente de variación promedio de 5.45. Se encontró que 38 casos (36.5%) exhibían aneuploidia de DNA; 42 casos presentaban ganglios linfáticos metastásicos con suficientes células tumorales, y 31% de estos casos tenían aneuploidia de DNA. La aneuploidia de los tumores primarios apareció correlacionada con las metástasis ganglionares y con la edad del paciente, en tanto que la aneuploidia de los ganglios metastásicos apareció significativamente correlacionada con la invasión de la serosa en el lugar del tumor primario. Los más importantes parámetros de pronóstico fueron la resección de tipo curativo, la invasión de la serosa, el tamaño del tumor y las metástasis distantes.

La aneuploidia tanto del tumor primario como de los ganglios metastásicos no apareció correlacionada con el pronóstico en este grupo de pacientes chinos.

Por lo tanto, planteamos que la aneuploidia de DNA en el cancer gástrico está asociada con el crecimiento del tumor pero no con su agresividad biológica.

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Authors and Affiliations

  1. Section of General Surgery, Department of Surgery, Tri-Service General Hospital, 8, Section 3, National Defense Medical Center, Ting-Chou Road, Taipei, Taiwan, Republic of China

    Kuo-Liang Shen M.D.

  2. Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China

    Chi-Hong Chu M.D.

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Shen, KL., Chu, CH. DNA ploidy and biologic aggressiveness of gastric adenocarcinoma in Chinese. World J. Surg. 18, 433–439 (1994). https://doi.org/10.1007/BF00316831

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