title: Relationship of DNA ploidy to histology and prognosis in rhabdomyosarcoma. Comparison of flow cytometry and image analysis.
abstract: BACKGROUND
  Although DNA ploidy correlates with prognosis in certain childhood cancers, e.g., neuroblastoma, its significance in rhabdomyosarcoma (RMS) is unclear and controversial.
  
  
  METHODS
  Ploidy by flow cytometry (FCM) and image analysis (IA) in 26 of 27 children with RMS (17 embryonal, 3 mixed embryonal/alveolar, 5 alveolar, 1 anaplastic, 1 ectomesenchymoma) and 4 adults with pleomorphic RMS were evaluated. Statistical comparisons were analyzed between DNA content and gender, age, localization, Intergroup Rhabdomyosarcoma Study (IRS) group, and histopathologic subtype. Survival analyses were performed by the Kaplan-Meier test using the approximate chi-square statistic for the log rank test.
  
  
  RESULTS
  The concordance rate between FCM and IA was 26 of 30 (87%); FCM was not performed in one tumor. Image analysis was more sensitive than FCM in detecting aneuploidy. Furthermore, DNA content was associated significantly with histologic subtype (P = 0.031); embryonal histology commonly was hyperdiploid (mean, 1.44; median, 1.27), whereas alveolar histology usually was near-tetraploid (mean, 1.83; median, 1.95). All four adult patients with pleomorphic RMS were aneuploid, with one showing multiple DNA peaks. No correlation between DNA content and survival was observed in the children with RMS. However, IRS group (P = 0.011) and patient age (P = 0.036) were independent prognostic indicators significantly related to survival. All adult patients died of their disease.
  
  
  CONCLUSIONS
  Although ploidy correlates with histologic subtype, DNA content is not significantly predictive of prognosis in patients with RMS. Age at diagnosis and IRS group are independent predictors of clinical outcome in children with RMS.
authors.affiliation: Department of Pathology, North Carolina Baptist Hospital, Bowman Gray School of Medicine, Winston-Salem, North Carolina.
authors.forename: S E
authors.initials: SE
authors.lastname: Kilpatrick
authors.forename: L A
authors.initials: LA
authors.lastname: Teot
authors.forename: K R
authors.initials: KR
authors.lastname: Geisinger
authors.forename: P L
authors.initials: PL
authors.lastname: Martin
authors.forename: D K
authors.initials: DK
authors.lastname: Shumate
authors.forename: N
authors.initials: N
authors.lastname: Zbieranski
authors.forename: G B
authors.initials: GB
authors.lastname: Russell
authors.forename: C D
authors.initials: CD
authors.lastname: Fletcher
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008297:Male; D011003:Ploidies; D011379:Prognosis; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000235:genetics* / Q000473:pathology; D012983:Soft Tissue Neoplasms / Q000235:genetics* / Q000473:pathology; D013194:Staining and Labeling; D016019:Survival Analysis