Deoxyribonucleic acid analysis facilitates the pretreatment identification of high-risk endometrial cancer patients.
OBJECTIVE
Our purpose was to assess the proficiency with which cytometrically determined deoxyribonucleic acid variables from pretreatment curettage specimens identify patients at high risk for extrauterine disease or posttreatment relapse.


METHODS
Flow cytometrically determined deoxyribonucleic acid ploidy, S-phase fraction, deoxyribonucleic acid index, and proliferative index were assessed in 140 paraffin-embedded curettage specimens containing endometrial carcinoma.


RESULTS
Although clinical staging identified only 19% of patients with advanced disease, 46% of surgical stages III and IV were aneuploid, 69% had an S-phase fraction > or = 9%, and 69% had a proliferative index > or = 14%. Documented recurrences and cancer-related deaths correlated with nondiploid patterns (29% of 140, 50% of recurrences, 54% of deaths), S-phase fraction > or = 9% (41% of 140, 67% of recurrences, 75% of deaths), and proliferative index > or = 14% (45% of 140, 73% of recurrences, 79% of deaths). Deoxyribonucleic acid index (< 1.5 vs > 1.5) provided additional stratification of aneuploid tumors (p < 0.01). Multivariate analysis identified the proliferative index as the most cogent independent prognostic factor (p < 0.01).


CONCLUSIONS
Deoxyribonucleic acid ploidy and proliferative activity in pretreatment curettage specimens identified the majority of patients at high risk for extrauterine metastasis and relapses.
Podratz
K C
KC
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905.
Wilson
T O
TO
Gaffey
T A
TA
Cha
S S
SS
Katzmann
J A
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003475:Curettage; D004273:DNA, Neoplasm / Q000032:analysis* / Q000235:genetics; D005260:Female; D006801:Humans; D008875:Middle Aged; D008940:Mitotic Index; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D009367:Neoplasm Staging; D011003:Ploidies; D011379:Prognosis; D012307:Risk Factors; D016196:S Phase; D016019:Survival Analysis; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000401:mortality
D004273:DNA, Neoplasm