Abstract
The DNA distribution pattern has been suggested to be of prognostic value in several malignant tumors in which diploidy is indicative of low malignancy potential. The present study retrospectively evaluates the DNA content in intestinal carcinoid tumors. The charts of 27 patients treated for carcinoid tumors between 1965 and 1984 were reviewed. Paraffin-embedded specimens from 22 primary tumors were available. The DNA content in individual cells was measured on histological sections of 4-μm thickness, according to a cytophotometric method based on light transmission measurements of Feulgen-stained nuclei. Seventeen tumors were localized to the small intestine, 1 to the appendix, 3 to the colon, and 1 to the rectum. There were 13 men and 9 women with a mean age of 59 years. Nine patients died of disseminated disease, with survival times ranging from 3 to 12 years (median: 5 years). For the 13 living patients, the follow-up times ranged from 8 months to 16 years and 8 months. All but 1 tumor showed a majority of their nuclear DNA values around the diploid level. One tumor had 87% nondiploid cells and 14% aneuploid cells. The patient underwent a radical operation and is disease free 2 years after surgery. According to this preliminary study, intestinal carcinoid tumors are rarely aneuploid. The patients also had fairly long survival times. Thus, these observations are in agreement with the fact that carcinoid tumors often have a relatively benign course compared to other malignant tumors of the intestinal tract.
Résumé
Il a été dit que le mode de distribution de l'ADN revêtrait une valeur de pronostic chez plusieurs cellules malignes où la diploïdie témoignerait d'un faible potentiel de malignité. L'étude rétrospective effectuée par les auteurs a eu pour but d'évaluer le contenu ADN dans les tumeurs carcinoïdes intestinales. Les observations de 27 malades opérés de tumeurs carcinoïdes de 1965 à 1984 ont été soumises à l'étude. Vingt-deux spécimens incorporés dans la paraffine ont été disponibles. L'ADN dans les cellules a été mesurée sur des coupes histologiques de 4 mm d'épaisseur par une méthode cytophotométrique basée sur les mesures de transmission de la lumière des noyaux colorés par le Feulgen. Dix-sept tumeurs concernaient l'intestin grêle, 1 l'appendice, 3 le colon et 1 le rectum. Elles s'étaient développées chez 13 hommes et 9 femmes dont l'âge moyen était de 59 ans. Neuf malades moururent de la généralisation de la maladie, les temps de survie allant de 3 à 12 ans (médiane: 5 ans). Pour les 13 malades en survie la durée de celle-ci s'étend de 8 mois à 16 ans et 8 mois. A l'exception d'une d'entre elles les tumeurs présentaient un taux d'ADN nucléaire très voisin du taux diploïde. Une tumeur présentait 87% de cellules non diploïdes et 14% de cellules aneuploïdes et le malade qui avait subi une opération radicale est en vie sans récidive 2 ans après l'intervention. En fonction de cette étude préliminaire on peut affirmer que les tumeurs carcinoïdes intestinales sont rarement aneuploïdes. Les malades ont une durée de survie assez longue. Ces observations concordent avec le fait que les tumeurs carcinoïdes ont une évolution relativement favorable par rapport aux autres tumeurs intestinales.
Resumen
Se ha sugerido que el patrón de distribución de DNA es de valor pronóstico en varios tumores malignos en los cuales la diploidia es indicativa de un bajo potencial de malignidad. El presente estudio evalúa retrospectivamente el contenido de DNA en tumores carcinoides intestinales. Las historias de 27 pacientes tratados por tumores carcinoides entre 1965 y 1984 fueron revisadas. Se encontraron disponibles especímenes montados en parafina provenientes de 22 tumores primarios. El contenido de DNA en células individuales fue determinado en cortes histológicos de 4 μm de espesor, de acuerdo al método citofotométrico basado en mediciones de transmisión de luz de núcleos coloreados con Feulgen. Diecisiete tumores estaban localizados en el intestino delgado, 1 en el apéndice, 3 en el colon y 1 en el recto. Hubo 13 hombres y 9 mujeres, con edad promedio de 59 años. Nueve pacientes murieron de enfermedad diseminada, con supervivencia entre 3 y 12 años (promedio: 5 años). Para los 13 pacientes sobrevivientes los tiempos de seguimiento oscilaron desde 8 meses hasta 16 años y 8 meses. Todos los tumores, con excepción de uno, exhibieron la mayoría de sus valores de DNA nuclear alrededor del nivel diploide. Un tumor poseía 87% de células no diploides y 14% de células aneuploides. Este paciente fue sometido a operación radical y se encuentra vivo y libre de enfermedad a los 2 años después de la cirugía. De acuerdo a este estudio preliminar, los tumores carcinoides intestinales son raramente aneuploides. Los pacientes exhiben supervivencias relativamente largas. Por consiguiente, estas observaciones están de acuerdo con el hecho de que los tumores carcinoides con frecuencia exhiben una evolución relativamente benigna en comparación con otras neoplasias malignas del tracto intestinal.
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References
Awrich, A.E., Irish, C.E., Vetto, R.M., Fletcher, W.S.: A twenty-five year experience with primary malignant tumors of the small intestine. Surg. Gynecol. Obstet.151:9, 1980
Moertel, C.G., Sauer, W.G., Dockerty, M.B., Baggenstoss, A.H.: Life history of the carcinoid tumor of the small intestine. Cancer14:901, 1961
Moertel, C.G., Hanley, J.A.: Combination chemotherapy trials in metastatic carcinoid tumor and the malignant carcinoid syndrome. Cancer Clin. Trials2:327, 1979
Hajdu, S.I., Winawer, S.J., Myers, W.P.L.: Carcinoid tumors: A study of 204 cases. Am. J. Clin. Pathol.61:521, 1974
Moertel, C.G., Dockerty, M.B., Judd, E.S.: Carcinoid tumors of the vermiform appendix. Cancer21:270, 1968
Johnson, L.A., Lavin, P., Moertel, C.G., Weiland, L., Dayal, Y., Doos, W.G., Geller, S.A., Cooper, H.S., Nime, F., Massé, S., Simson, I.W., Summer, H., Fölsch, E., Engström, P.: Carcinoids: The association of histological growth pattern and survival. Cancer51:882, 1983
Bowman, G.A., Rosenthal, D.: Carcinoid tumors of the appendix. Am. J.Surg.146:700, 1983
Mårtenson, H., Nobin, A., Sundler, F.: Carcinoid tumors in the gastrointestinal tract—an analysis of 156 cases. Acta Chir. Scand.149:607, 1983
Sabback, M.S., O'Brien, P.H.: Clinical study of 81 gastrointestinal carcinoid tumors. South. Med. J.72:386, 1979
Teitelbaum, S.L.: The carcinoid: A collective review. Am. J. Surg.123:564, 1972
Zeitels, J., Naunheim, K., Kaplan, E.L., Strauss, F., II: Carcinoid tumors: A 37-year experience. Arch. Surg.117:732, 1982
Atkin, N.B.: Prognostic significance of ploidy level in human tumors. I. Carcinoma of the uterus. J. Natl. Cancer Inst.56:909, 1976
Atkin, N.B., Kay, R.: Prognostic significance of modal DNA value and other factors in malignant tumors, based on 1465 cases. Br. J. Cancer40:210, 1979
Auer, G., Caspersson, T., Wallgren, A.: DNA content and survival in mammary carcinoma. Anal. Quant. Cytol.3:161, 1980
Auer, G., Eriksson, E., Azavedo, E., Caspersson, T., Wallgren, A.: Prognostic significance of nuclear DNA content in mammary adenocarcinoma in humans. Cancer Res.44:394, 1984
Auer, G., Zetterberg, A.: The prognostic significance of nuclear DNA content in malignant tumors of breast, prostate and cartilage. Adv. Clin. Cytol.2:123, 1984
Cohn, K., Bäckdahl, M., Forsslund, G., Auer, G., Lundell, G., Löwhagen, T., Tallroth, E., Willems, J.-S., Zetterberg, A., Granberg, P.-O.: Prognostic value of nuclear DNA content in papillary thyroid carcinoma. World J. Surg.8:474, 1984
Erhardt, K., Auer, G., Björkholm, E., Forsslund, G., Moberger, B., Silfverswärd, C., Wicksell, G., Zetterberg, A.: Prognostic significance of nuclear DNA content in serious ovarian tumors. Cancer Res.44:2198, 1984
Forsslund, G., Cedermark, B., Öhman, U., Erhardt, K., Zetterberg, A., Auer, G.: The significance of DNA distribution pattern in rectal carcinoma: A preliminary study. Dis. Colon Rectum.27:579, 1984
Moberger, B., Auer, G., Forsslund, G., Moberger, G.: The prognostic significance of DNA measurements in endometrial carcinoma. Cytometry5:430, 1984
Zetterberg, A., Auer, G.: Ploidy level and grade of malignancy in some solid tumors. In UCLA Symposia on Molecular and Cellular Biology. New Series. Proceedings of a CETUS-UCLA Symposium, Steamboat Springs, Colorado, March 3–17, 1984, vol. 17, Genes and Cancer, pp. 59–67
Bäckdahl, M., Auer, G., Forsslund, G., Granberg, P.-O., Hamberger, B., Lundell, G., Löwhagen, T., Zetterberg, A.: Prognostic value of nuclear DNA content in follicular thyroid tumors. Acta Chir. Scand.152:1, 1986
Bäckdahl, M., Tallroth, E., Auer, G., Forsslund, G., Granberg, P.-O., Lundell, G., Löwhagen, T.: Prognostic value of nuclear DNA content in medullary thyroid carcinoma. World J. Surg.9:980, 1985
Gaub, J., Auer, G., Zetterberg, A.: Quantitative cytochemical aspects of a combined Feulgen naphtol yellow S staining procedure for the simultanous determination of nuclear and cytoplasmic protein and DNA in mammilian cells. Exp. Cell. Res.92:323, 1975
Adams, L.R.: A photographic cytophotometric method which avoids distributional error. Acta Cytol.12:3, 1968
Nobin, A.: Diagnostik, klassifikation och behandling av endokrina tarmtumörer. Lärkartidningen82:299, 1985
Wilander, E., Bengtsson, A., Lindgren, P.G., Lundqvist, M., Norheim, I., Öberg, K.: Nuclear DNA in intestinal carcinoid tumors: A study before and after cytotoxin (streptozotocin and 5-fluorouracil) treatment. Cancer56:793, 1985
Bäckdahl, M., Cohn, K., Auer, G., Forsslund, G., Granberg, P.-O., Lundell, G., Löwhagen, T., Willems, J.-S., Zetterberg, A.: Comparison of nuclear DNA content in primary and metastatic papillary thyroid carcinoma. Cancer Res.45:2890, 1985
Auer, G., Arrhenius, E., Granberg, P.-O., Fox, C.H.: Comparison of DNA distributions in primary human breast cancer and their metastases. Eur. J. Cancer.16:273, 1979
Auer, G., Fallenius, A., Erhardt, K., Sundelin, B.: Progression of mammary adenocarcinomas as reflected by nuclear DNA content. Cytometry5:420, 1984
Meek, E.S.: The cellular distribution of deoxyribonucleic acid in primary and secondary growths of human breast cancer. J. Pathol. Bacteriol.82:167, 1962
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Cohn, G., Erhardt, K., Cedermark, B. et al. DNA distribution pattern in intestinal carcinoid tumors. World J. Surg. 10, 548–553 (1986). https://doi.org/10.1007/BF01655522
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DOI: https://doi.org/10.1007/BF01655522