Prognostic evaluation of DNA flow cytometry and histo-morphological criteria in renal cell carcinoma.
Clinical, histological and flow cytometric data (DNA content, S phase fraction) were related to clinical behaviour in 124 patients with renal cell carcinoma followed up for more than nine years. 69% of the tumours were diploid and 31% were aneuploid. The S phase fraction (SPF) ranged between 0.5% and 17.2% and the mean (s.e.) was 3.8 (0.3)%. The SPF was higher in aneuploid than in diploid tumours [mean, s.e., 2.6 (0.2)% vs. 6.4 (0.6)%, p < 0.001]. DNA ploidy was not related to any of the analysed features, while S phase was related to nuclear grade (p < 0.001), combined nuclear grade (p = 0.0025) and node metastasis at diagnosis (p = 0.036). In a multivariate analysis, the recurrence-free survival of M0 tumours was independently predicted by combined nuclear grade (p < 0.001), M/V index (p = 0.007), T-category (p = 0.011) and location (left/right) (p = 0.022). Survival in the entire cohort was independently related to T-category (p < 0.001), M/V index (p = 0.001) and DNA ploidy (p = 0.050). Survival of M0 tumours was independently related to M/V index (p < 0.001), DNA ploidy (p = 0.005) and T-category (p = 0.003). DNA aneuploidy was related to favorable disease outcome both in univariate and multivariate analysis in the entire series and in all the subanalyses. The results suggest that genomic instability in aneuploid cells may reduce their capacity to resist immunological host response or aneuploid tumours may be more sensitive to treatment.
Eskelinen
M
M
Department of Surgery, University of Kuopio, Finland.
Lipponen
P
P
Nordling
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000235:genetics / Q000401:mortality* / Q000473:pathology; D004273:DNA, Neoplasm / Q000032:analysis*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007680:Kidney Neoplasms / Q000235:genetics / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011003:Ploidies; D011379:Prognosis; D015996:Survival Rate
D004273:DNA, Neoplasm