Intratumoral DNA ploid heterogeneity and its clincal-pathological significance in esophageal squamous cell carcinoma

目的为了研究食管鳞状细胞癌ＤＮＡ倍体异质性及其临床病理学意义，采用多点取材和流式细胞技术对８０例食管鳞状细胞癌标本的ＤＮＡ倍体进行了研究。方法每个标本从３个不同部位取材，８０例标本共取２４０个流式检测样品。采用ＦＡＣＳ－４２０型流式细胞仪（ＢｅｃｔｏｎＤｉｃｋｉｎｓｏｎＣｏ．ＳａｎＪｏｓｅ，ＣＡ）进行分析。校定仪器ＣＶ值为３％～５％。每个样品测量１０，０００～２０，０００个细胞。根据ＤＮＡ指数（ＤＮＡｉｎｄｅｘ，ＤＩ）确定倍体类型，ＤＩ＝１±０．１时为２倍体（２Ｃ）；０．９＜ＤＩ＞１．１时为异倍体（ａｎｅｕ ｐｌｏｉｄｙ，ＡＮ）。当一个标本的３个检测样品的Ｇ０／Ｇ１峰相互不同或３个峰的ＤＩ值相差大于２ＣＤＩ值的１０％时，该肿瘤被称为倍体异质性肿瘤（ｐｌｏｉｄｈｅｔｅｒｏｇｅｎｏｕｓｔｕｍｏｒ，ＰＨＴ），如果一个标本的３个样品的ＤＮＡ倍体类型相互一致，则称为非倍体异质性肿瘤（ｎｏｎ－ＰＨＴ，Ｎ－ＰＨＴ）。结果ＤＮＡ指数范围为０．７７～１．７４，ＤＮＡＡＮ检出率为８８．８％（７１／８０）。共检出ＰＨＴ３８例（４７．５％，３８／８０）。倍体异质性与肿瘤的侵润、转移和患者的预后有关，与肿瘤的大小及组织学分级无关。结?

Intratumoral DNA ploid heterogeneity and its clincal-pathological significance in esophageal squamous cell carcinoma

Objective To investigate the intratumoral DNA ploid heterogeneity in esophageal squamous cell carcinoma and its clinical-pathological significance.Methods Two hundred and forty samples for flow cytometric DNA analysis were taken from 3 different parts of each tumor in 80 cases of esophageal squamous cell carcinoma. DNA measurement was performed by a FACS-420 analyzer. DNA ploid patterns were determined according to the DNA index(DI).The ploid heterogenous tumor(PHT) was refered to that different G0/G1 peaks were present in a tumor and the difference more than 10% of the diploid DNA content(DI)in the DI value among 3 peaks in each tumor specimen.Comparison of clinical- pathological characterestics was performed beween PHTs and N-PHT which had a same ploid pattern in 3 sampling spots of each tumor(non-PHT).Results DNA indices ranged from 0.77～1.74,and the incidence of DNA AN was 88.8%(71/80) in this series.Of 80 cases,38 cases(47.5%,38/80)showed intratumoral heterogeneity in DNA ploidy.The heterogeneity in DNA ploidy was related to the extent of wall penetration by the tumor,the incidence of lymph node metastasis and the patient's prognosis,not to histological grades and size of the tumor.Conclusion DNA PH in esophageal squmous cell carcinoma may be a more exact indicator reflecting the biological characteristics of the tumor and patient's prognosis than DNA AN from single site sampling.