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6th ESACP Congress, Heidelberg, April 7-11, 1999 |
A134
The DNA cytometry has been established as a valuable tool for prognostic
evaluaton of tumor material. From 799 primary breast cancers we analyzed
simultaneously the DNA content of tumor cells by both image and flow
cytometry. The overall coincidence between the determined DNA pIoidy with
both methods was 71 % indicating a good correlation (r=0.68, p<0.001).
In addition, we compared the DNA ploidy and the S-phase-fraction (SPF)
to the lymph node status (LNS) at the time of operation and to the uPA
antigen levels of tumor tissue extracts, since these are prognostic
parameters with well documented prognostic impact.
As expected we found with both methods a significant correlation
(Chi Square, p<0.0007) to LNS with a higher percentage of aneuploid
breast cancers with lymph node metastasis (60%) as compared to diploid
tumors (42 %). The SPF determined by flow cytometry was also significantly
correlated with the LNS (Mann Withney, p < 0.001). The uPA antigen level
of both tetraploid (3.99 ng/mg protein) and aneupIoid (4.72 ng/mg) tumors
was interestingly significantly higher as compared to diploid (3.39 ng/mg)
tumors (Kruskall Wallis, p<0.001). To analyze the prognostic relevance of
DNA measurements, the resuIts were evaluated in a subgroup of 99 patients
with primary invasive ductal carcinomas (median follow up 29 ( 15 month).
Whereas we found SPF as an independent prognostic parameter in univariate
analysis (p = 0.037, cut off SPF=10 %), DNA-ploidy failed tightly to be
significant (p=0.06). In the analyzed patient group, however, the usual
clinicopathological prognostic markers such as LNS (p=0.004),
Bloom-Richardson-Grading (p=0.0002) as well as the biochemical markers
such as uPA- (p=0.038) and PAI-1-antigen levels (p=0.007) showed also
significant correlation on disease-free survival in univariate analysis.
In conclusion, the determination of DNA content by flow cytometric techniques
in comparison to other prognostic parameters seems to be useful for
prognostic evalution in breast cancer.
THE RELEVANCE OF DNA PLOIDY, BIOCHEMICAL MARKERS AND CLINICOPATHOLOGICAL
FEATURES FOR PROGNOSIS PREDICTION IN BREAST CANCER
Theissig F, Kotzsch M, Dimmer V, Haroske G, Luther TH, Kunze KD
Institute of Pathology, Dresden University of Technology, Germany