乳腺癌ER、CEA、DNA含量测定及其与预后的关系

用ＡＢＣ免疫组化技术对７４例乳腺癌根治术的标本进行ＥＲ和ＣＥＡ的测定，并用显微分光光度计对其中３４例标本进行ＤＮＡ含量的测定，结果表明：①ＥＲ阳性率与年龄、月经状况、肿瘤大小无关。随组织学分级开高而降低；②ＣＥＡ阳性率与年龄、月经状况、组织学分级无关。与肿瘤大小、淋巴结转移有关（ｐ＜０．０５）；③患者５年生存率与年龄、月经状况无关。与临床分期、组织学分级有关；④ＤＮＡ倍体水平绝经期以二倍体为主，绝经后以非整倍体为主。非整倍体随组织学分级增加和腋淋巴结转移数增多而增高。二倍体组５年生存率高于非整倍体组（Ｐ＜０．０５）；⑤ＥＲ和ＣＥＡ之间的关系与组织学分级和腋淋巴结转移状况具有相关性；⑥乳腺癌组织ＤＮＡ含量与ＥＲ表达呈负相关，与ＣＥＡ表达呈正相关。ＥＲ（＋）或ＣＥＡ（－）及ＤＮＡ含量的均值低者预后好。ＥＲ（－）、ＣＥＡ（＋）、非整倍体组预后最差。     

DNA计量图像分析诊断子宫平滑肌肿瘤的特异性及标准化检测

应用电子计算机辅助ＤＮＡ影像计量分析仪（ＣＭ１ＤＮＡＣｙｔｏｍｅｔｅｔ．ＨＵＮＤ，Ｗｅｔｚｌａｒ，Ｇｅｒｍａｎｙ）测量３０例人正常子宫平滑肌、内膜上皮、纤维及淋巴细胞核ＤＮＡＩＯＤ值，以确定子宫组织特异性正常二倍体参照细胞及其校正因子。测量８０例子宫平滑肌瘤细胞核ＤＮＡ含量，发现各ＤＮＡ计量结果与正常平滑肌近似，无１例出现干系ＤＮＡ非整倍体和＞９ｃＥＥ，有４例出现＞５ｃＥＥ。测量３２例生长活跃的子宫平滑肌瘤，１８例检出干系ＤＮＡ非整倍体，１例检出＞９ｃＥＥ，１１例检出＞５ｃＥＥ，测量２７例子宫平滑肌肉瘤，２２例出现干系ＤＮＡ非整倍体，５例出现＞９ｃＥＥ，１８例出现＞５ｃＥＥ。本文结果表明，用于系ＤＮＡ非整倍体和＞９ｃＥＥ作为指标诊断子宫平滑肌瘤的特异性均为１００％，诊断子宫平滑肌肉瘤的敏感性分别为８１％和１９％，对生长活跃的子宫平滑肌瘤恶性性质的预测具有重要意义。＞５ｃＥＥ这一指标阈值不适合用于对子宫平滑肌肿瘤良、恶性质的判断。     

卵巢上皮性肿瘤细胞DNA含量测定及其临床意义

作者采用流式细胞仪对３８例卵巢交界癌２０例卵巢恶性肿瘤及４例正常卵巢进行ＤＮＡ含量测定。结果：（１）交界瘤非整倍体率为１６％，恶性肿瘤非整倍体率为１００％；（２）非整倍交界瘤与恶性肿瘤之间ＤＩ值，ＰＩ值，Ｓ期细胞比率无差异（Ｐ〉０．０５），（３）ＤＩ〈１．２１是判断交界瘤的客观指标，符合率８７．９３％，（４）ＤＩ值是唯一影响预后的因素。     

流式细胞计测定食管癌细胞 DNA 含量和临床及病理特性的关系

本文用流式细胞检测了36例食管癌切除标本的DNA含量,结果发现,DNA倍体水平差异较大,范围为1.68C～8.16C,大多数食管癌为非整倍体DNA含量,其中少数病人在同一标本中同时发现两种不同的非整倍体。而且,食管癌细胞的DNA含量和肿瘤病变长度、局部淋巴结转移、食管外侵犯以及病理分级有密切关系;以二倍体肿瘤预后较好,且病理分化较高。而非整倍体肿瘤则相反。     

胃MALT淋巴瘤浸润子宫肌瘤病理及DNA研究

［目的］对胃粘膜相关淋巴组织（ＭＡＬＴ）淋巴瘤浸润子宫平滑肌瘤临床病理、ＤＮＡ倍体进行研究。［方法］标本采用常规石蜡切片、ＨＥ染色及ＡＢＣ法免疫组化染色,并对Ｆｅｕｇｅｌｎ染色切片用细胞影像仪对瘤细胞的ＤＮＡ倍体进行测定。［结果］胃粘膜、粘膜下层、肌层及平滑肌瘤内均可见弥漫多量密集成片的中心细胞样瘤细胞浸润。胃、胃大弯淋巴结淋巴瘤细胞ＤＮＡ质量分布呈单个主峰,瘤细胞ＤＮＡ呈非整倍体。子宫肌瘤细胞ＤＮＡ的质量分布为两个峰,主峰为二倍体,次峰为非整倍体。本例预后不良。［结论］ＭＡＬＴ淋巴瘤浸润子宫肌瘤须与子宫原发性恶性淋巴瘤、慢性淋巴细胞性白血病浸润子宫及子宫内膜间质肉瘤相鉴别。随访结果表明ＤＮＡ指数对于患者预后的判断是一项重要的参考指标。     

胃低分化腺癌细胞核DNA含量、癌细胞聚合度与癌的转移

测定不同脏器实体肿瘤细胞核的DNA含量可预测肿瘤的恶性潜能。非整倍体肿瘤的恶性程度一般高于二倍体肿瘤。作者对伴有浆膜浸润的胃低分化腺癌手术切除标本进行研究,分析了核DNA的分布模式、癌细胞的组织学聚合方式及其与预后的关系,以探讨低分化胃腺癌的恶性潜能。对日本100例胃低分化腺癌伴浆膜浸润患者的手术切除标本,做常规石蜡切片,苏木素-伊红染色观察组织学形态,按细胞聚合方式     

细胞核DNA含量与神经系统良恶性肿瘤关系的研究

细胞核ＤＮＡ含量与神经系统良恶性肿瘤关系的研究王占祥１张传山２章翔１晏培松２张志文１张剑宁１宋少军关键词星形细胞瘤髓母细胞瘤听神经瘤ＤＮＡ图象分析目前，对全身不同脏器肿瘤的形态计量学和ＤＮＡ含量定量分析研究已得到较广泛应用，在判定病变的良恶性和恶性肿...     

食管鳞癌DNA和RNA测定及其预后关系的研究

目的　探讨食管鳞癌ＤＮＡ异倍体和ＲＮＡ含量变化与预后的关系。方法　应用流式细胞技术对６２例随访患者的石蜡标本进行研究。结果　术后生存５年以上患者的ＤＮＡ异倍体７８．１％（２５／３２）,ＲＮＡ含量为２０．５３±４．２１。术后半年内死亡者ＤＮＡ为９３．３％ （２８／３０）,ＲＮＡ含量为２４．８４±６．３５,两者均有显著性差异。ＤＮＡ异倍体和ＲＮＡ含量与病期、恶性程度和淋巴结转移有关。结论　ＤＮＡ和ＲＮＡ测定是判断食管鳞癌病期、恶性程度、有无淋巴结转移和预后的重要指标。表２　食管癌不同病期与ＤＮＡ和ＲＮＡ含量的关系生存时间（年） 病期 例数 ＤＮＡ２Ｃ Ａｎ ％ＲＮＡ含量（ｘ±ｓ）＞ ５ Ⅰ ３ ２ １ ５０ １０．６１±０．２４Ⅱ １９ ４ １５ ７８．９ ２１．５６±３．４１Ⅲ ８ １ ７ ８７．５ ２３．９８±２．１１Ⅳ ２ ０ ２ １００ ２６．１２±１．５６＜ ０．５ Ⅰ ０ ０ ０Ⅱ １１ １ １０ ９０．９ ２３．４５±４．２７Ⅲ １３ １ １２ ９２．３ ２４．７６±２．８７Ⅳ ６ ０ ６ １００ ２７．３１±２．５６表３　食管鳞病分化程度与ＤＮＡ和ＲＮＡ含量的关系生存时间（年） 分化 例数 ＤＮＡ２Ｃ Ａｎ ％ＲＮＡ含量（ｘ±ｓ）＞ ５ Ⅰ ５ ３     

宫颈腺癌DNA含量、S期细胞比率测定的意义

用流式细胞计对３４例宫颈腺癌进行了分析，结果①二倍体、近二倍体及非整倍体肿瘤的ＳＰＦ高于正常宫颈组织；②宫颈内膜型腺癌ＤＩ低于透明细胞癌，高、中、低分化腺癌ＤＩ依次递加（Ｐ＜０．０５，Ｐ＜０．０１），组织学类型及分极间的ＳＰＦ无显著性差异；③无瘤生存期≥３年组具高ＳＰＦ者（１／８）低于＜３年组（１５／２１）（Ｐ＜０．０１），而与ＤＮＡ含量无关，３例放疗后死于肺转移的患者均具高ＳＰＦ，表明具高ＳＰＦ患者治疗后易复发或远处转移，预后差。提示ＳＰＦ较ＤＮＡ含量对预后估计更有价值。     

甲状腺滤泡性肿瘤DNA含量与AgNOR计数研究

目的：探讨ＤＮＡ含量与ＡｇＮＯＲ对甲状腺良恶性滤泡性肿瘤的鉴别诊断价值。方法：应用流式细胞术和胶体银染技术对９例正常甲状腺组织和３６例滤泡生肿瘤（２２例腺瘤和１４例腺癌）进行ＤＮＡ含量分析和ＡｇＮＯＲ计数。结果：１４例滤泡性癌中，１１例为ＤＮＡ异倍体，而２２例滤泡性腺瘤仅１例为ＤＮＡ异倍体，且伴有不典型增生。ＡｇＮＯＲ由正常甲状腺组织、滤泡性腺瘤至滤泡性癌逐渐增加，相互之间有显著性差异（Ｐ〈０．０     

肾上腺皮质肿瘤增殖活性检测及预后意义

 目的：探讨细胞增殖活性检测对肾上腺皮质肿瘤的诊断价值和预后。方法：采用DNA含量测定、AgNOR和PCNA染色对正常肾上腺皮质、皮质增生、腺瘤和癌进行细胞增殖活性检测。结果：正常肾上腺与皮质增生DNA含量、AgNOR计数、PCNA指数均值相接近(P>0.05),DNA倍体主要呈二倍体。腺瘤较增生组相比三种指标均值相差显著(P<0.01)。结论：提示细胞增殖活性检测对肾上腺皮质肿瘤诊断和预后判断有较大参考价值。     

Prognostic implications of the ploidy pattern of the nuclear DNA in hepatocellular carcinomas

The nuclear DNA contents of paraffin-embedded specimens of 41 cases of a hepatocellular carcinoma have been measured by means of flow cytometry. Results have indicated that 25 cases (61%) were diploid and 16 cases (39%) were aneuploid. In the aneuploid cases, the serum AFP level was found to be higher and stage more advanced. We also found that patients with aneuploid tumors had a poorer prognosis than those with diploid tumors, this fact uncovered by means of a Cox's proportional hazard model. In conclusion, the ploidy pattern of the nuclear DNA may serve as a useful prognostic marker for a hepatocellular carcinoma.     

Flow cytometric DNA ploidy in salivary gland tumours

This study on 279 tumours of the salivary glands was conducted to analyse whether the assessment of DNA ploidy by flow cytometry may assist histopathology in discriminating benign from malignant types of tumours. The group of benign tumours included 164 pleomorphic adenomas, 51 Warthin's tumours, 7 basal cell adenomas, 2 lipomas as well as 5 other different tumours. All of the 229 benign tumours were diploid. The malignant tumours consisted of 18 adenoid cystic adenomas, 10 mucoepidermoid carcinomas, 5 acinic cell carcinomas, 5 carcinoma in pleomorphic adenoma as well as of 12 other malignancies belonging to 7 different tumour entities. Twelve of 50 malignant salivary gland tumours were aneuploid. There was no significant relationship between the DNA ploidy status and histopathological grading, lymph node metastasis and local recurrence development, respectively. In three cases which initially were taken for pleomorphic adenomas by routine histological examination, aneuploid cell populations exposed by DNA flow cytometric analysis gave rise to a closer inspection of the suspect lesions. Examination of consecutive slides actually revealed small assemblies of carcinoma cells that required a final diagnosis as non-invasive carcinoma in pleomorphic adenoma. The most obvious value of DNA flow cytometry in salivary gland tumours is thus its contribution to assist histopathology in identifying potentially malignant lesions.     

Flow cytometric analysis of renal cell carcinoma

Forty cases of renal cell carcinoma were studied retrospectively by flow cytometry and DNA contents of the cancer cells were measured. The results indicated that the incidence of aneuploid tumor was 57.5% (23/40), diploid tumor or quasi-diploid tumor 42.5% (17/40). DNA ploidy was strictly correlated to histopathological grade, clinical stage, cancer cell type and survival time. Therefore, analysis of cellular DNA ploidy of renal cell carcinoma is of prognostic value for renal cell carcinoma.     

Flow cytometric analysis of nuclear DNA content in patients with recurrent epithelial ovarian cancer

Numerous reports have recently indicated that the DNA content of various malignant tumors can be of great value in predicting biological behavior and prognosis of the tumors. This study was undertaken to determine the nuclear DNA content in the primary and recurrent ovarian carcinoma of the same 20 consecutive patients by flow cytometry, and the results on clinical outcome was examined. The tissue samples of the recurrent tumors were obtained at second-look laparotomy. Of the primary tumors, 12 were diploid, 4 were pure aneuploid, and 4 were "mosaic", while of the recurrent tumors, 17 were diploid and 3 showed pure aneuploid. No significant difference of the DNA index at recurrence was observed. DNA ploidy was preserved in 12 out of 20 patients at recurrence. The time to recurrence after the initial treatment showed no significant difference versus DNA ploidy and change of ploidy. The sites and status of recurrence differed by DNA ploidy. At recurrence, the patients with DNA diploidy had a tendency to survive longer than those with DNA aneuploidy. The determination of DNA ploidy at recurrence may be useful as a variable parameter in predicting the survival of patients with ovarian carcinomas.     

Prognostic value of static cytometry in transitional cell carcinoma of the bladder: recurrence rate and survival in a group of patients at 10 years follow-up

Many studies have indicated that nuclear DNA content evaluation can be used to predict biological behavior of transitional cell carcinoma (TCC) of the bladder. Some authors also indicated that static cytometry is more useful in DNA content analysis than flow cytometry. The aim of the present study was to evaluate the prognostic significance of DNA ploidy in TCC of the bladder, performed by using static cytometry with an image analyzer, and monitoring patients at 10 years follow-up. Thirty-one consecutive patients underwent transurethral or open surgery for bladder tumors, and neoplastic tissue samples taken from each patient were imprinted on glass slides and sent for histopathological and DNA content evaluation. DNA ploidy evaluation was performed using a CAS 200 image analyzer. Nuclear DNA content evaluation was compared to patient follow-up on recurrence, progression or survival performed 10 years after surgery. Pathological evaluation demonstrated the presence of superficial TCC in 23 patients, while 8 had an invasive bladder tumor. Twenty-nine tumor samples were adequate for DNA content measurement, with 13 showing diploid DNA content and 16 with aneuploid DNA content. At 10 years follow-up, all patients with aneuploid DNA content demonstrated a lower survival time (p=0.049) and higher recurrence rate (p=0.0346). A log-rank test demonstrated that stage, grade and nuclear DNA content are the most useful prognostic parameters for predicting the biological behavior of TCC of the bladder. These results confirm that static cytometry is a good and reliable method to evaluate DNA tumor content and considered a useful prognostic parameter for predicting recurrence rate, disease progression or survival in patients affected by bladder tumors.     

So-called carcinosarcoma of the esophagus: A clinicopathologic, immunohistochemical and DNA flow-cytometric analysis of 6 cases.

Six cases of carcinosarcoma of the esophagus were studied clinicopathologically, immunohistochemically and with DNA flow cytometry. Transitional areas with morphology intermediate between carcinoma and sarcoma were found microscopically in all cases. Immunohistochemically, the carcinomatous areas contained keratin-positive cell components in all cases while vimentin-positive cells were found in sarcomatous areas in 5 cases. By DNA flow analysis of microdissection, the sarcomatous components of the tumors showed an aneuploid pattern with one exception, in contrast the carcinomatous components were diploid in all cases. In these few cases, PCNA, S-phase fraction and the mitotic rate were extremely high, apparently indicating a correlation with malignant behavior. Accordingly, examination by immunohistochemistry and DNA ploidy is useful for the analysis of biological properties in the so-called carcinosarcoma of the esophagus.     

Nuclear DNA content and morphological characteristics in the prognosis of adrenocortical carcinoma.

Prognostic factors are needed for the management of patients with adrenocortical tumours. For this reason, the nuclear DNA content of patients with adrenocortical tumours was analysed by flow cytometry. The relationships between nuclear DNA content, histological indices, and clinical parameters were studied. DNA ploidy could be evaluated in 54 carcinoma and 31 adenoma patients. Twenty-one (68%) of the adenomas, and 6 (11%) of the carcinomas, were DNA diploid. Hypo/Hyperdiploidy was found in 5 (16%) of the adenomas, and 15 (28%) of the carcinomas. The remaining patients had a DNA index above 1.40. A shorter survival was found in patients with diploid carcinomas (P < 0.05). A longer disease-free survival was seen in patients with hypo/hyperdiploid carcinomas (P < 0.05). Nuclear DNA content was not related to the histological index, nor to clinical parameters. We conclude that nuclear DNA content is related to (disease-free) survival of patients with adrenocortical carcinomas. An adenoma-carcinoma sequence may be present in the adrenal cortex. In adrenocortical tumours ploidy evolution appears to be different than that observed in other solid tumours.     

Accuracy of the bronchoscopic DNA content analysis of non-small-cell lung carcinoma.

To assess the accuracy of the bronchoscopic DNA content analysis, samples of non-small-cell lung carcinomas (NSCLC) were investigated by means of flow cytometry. Samples were dissociated using the detergent Triton X-100. In 58 NSCLC cases, 39 (67%) had DNA aneuploid tumors. We compared the DNA indices of bronchoscopic brushing samples with 21 corresponding surgical samples. In 16 (76%) cases, DNA ploidy of both bronchoscopic and surgical samples were in concordance. In 3 (14%) cases, both bronchoscopic and surgical sample showed DNA aneuploidy, but the number of the DNA aneuploid stem cell lines was different. The cause of these differences was ascribed to the intratumor DNA heterogeneity. In 2 (10%) cases, the bronchoscopic sample showed DNA diploidy, but the surgical sample showed DNA aneuploidy. In these cases, tumor cells obtained by bronchoscopic brushing were so few that the small DNA aneuploid peak was undetectable in the DNA histogram. But the tumor DNA ploidy was evaluated correctly in 90% of 21 cases using bronchoscopic samples. Consequently, despite some drawbacks, the DNA ploidy diagnosis using bronchoscopic samples in this relatively small study, was almost as reliable as surgical samples.     

嗜铬素A和突触素在肾上腺肿瘤中的表达及其临床意义

目的探讨嗜铬素A（CgA）和突触素（Syn）在各型肾上腺肿瘤中的表达及其临床意义。方法对69例肾上腺肿瘤和4例正常肾上腺组织运用免疫组化方法进行组织染色,研究C外和Syn的表达,并采用x^2检验进行统计学分析。结果在正常肾上腺组织,CgA和Syn主要表达于髓质。CgA在全部25例嗜铬细胞瘤中均呈阳性表达,而在肾上腺皮质肿瘤中极少表达;Syn在肾上腺皮质腺瘤、皮质癌、嗜铬细胞瘤及肾上腺转移癌的阳性表达率分别为96．4％（27／28）、87．5％（7／8）、96．0％（24／25）和75．0％（6／8）。结论CgA在肾上腺皮质与髓质肿瘤间、嗜铬细胞瘤与恶性嗜铬细胞瘤间的表达率差异有统计学意义。CgA、Syn可作为标志物对各型肾上腺肿瘤进行鉴别诊断。