title: Proliferative cell indices measured by DNA flow cytometry in node-negative adenocarcinomas of breast: accuracy and significance in cytokeratin-stained archival specimens.
abstract: Proliferative rates of 73 node-negative adenocarcinomas of breast with 5-year or greater follow-up were studied using cytokeratin staining in two-parameter DNA flow cytometry of archival specimens. Quality control data of accuracy of the measurements were determined and all analyses were compared with single-parameter results of the same specimens, using demarcated tumor areas, quadruple analyses, and computerized nonspecific staining subtraction. Mitotic rates of the same samples correlated highly significantly with the S-phase fractions and proliferative index (S + G2 + M phases), especially for the cytokeratin data. The predictive value of mitotic rates was found significant, but that of the DNA flow-cytometry-obtained indices was not, probably because of low numbers of deaths in this study. The cytokeratin method identified heteroploid tumors containing a diploid cell population not identifiable by single-parameter analysis. In conclusion, cytokeratin staining can be reliably applied to DNA flow cytometry of archival specimens giving accurate ploidy, S-phase fractions, and proliferative index data limited almost exclusively to neoplastic cell populations. This will permit large-scale retrospective studies aimed at establishing the usefulness of DNA flow cytometry for clinical decisions on therapy of surgically removed node-negative adenocarcinomas of breast.
authors.affiliation: Department of Pathology, University Hospital, London, Ontario, Canada.
authors.forename: J V
authors.initials: JV
authors.lastname: Frei
authors.forename: K
authors.initials: K
authors.lastname: Rizkalla
authors.forename: V J
authors.initials: VJ
authors.lastname: Martinez
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology*; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology*; D002455:Cell Division; D004273:DNA, Neoplasm / Q000032:analysis*; D005434:Flow Cytometry; D006801:Humans; D007633:Keratins / Q000032:analysis*; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D004273:DNA, Neoplasm; D007633:Keratins