A search for prognostic factors in cancer of the pancreatic head: the significance of the DNA ploidy pattern.
Using flow cytometry after the nuclear isolation and staining of tissue specimens, the significance of the DNA ploidy pattern as a prognostic factor in cancers of the head of the pancreas has been evaluated in 33 patients who underwent a pancreatic cancer resection. In addition to the DNA ploidy pattern, the size of the tumour, regional lymph node involvement, the tumour's histopathological grade and the results of a curative resection were also evaluated as prognostic factors. The results of a univariate analysis revealed that the survival rate was significantly higher for patients with a diploid tumour (n = 20) than for patients with an aneuploid tumour (n = 13) (P < 0.001). Furthermore, survival rates were significantly better for patients with a T1 tumour than with a T2 or T3 tumour (P < 0.001), for patients without positive lymph node involvement than for those with positive lymph nodes (P < 0.001), for patients with well-differentiated adenocarcinomas (G1) than for those with moderately differentiated (G2) or poorly differentiated (G3) adenocarcinomas, and for patients who underwent a curative resection than for those who underwent a non-curative resection (P < 0.005). A multivariate analysis revealed significant prognostic differences in the DNA ploidy pattern (P < 0.001), the frequency of a curative resection (P < 0.001), regional lymph node involvement (P < 0.05), and in the tumour's histopathological grading (P < 0.05) but not its size. This study has found the DNA ploidy pattern to be the most significant prognostic factor (chi 2 value: 38.1).
Takada
T
T
First Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Yasuda
H
H
D000230:Adenocarcinoma / Q000235:genetics / Q000473:pathology / Q000556:secondary / Q000601:surgery; D000782:Aneuploidy; D002467:Cell Nucleus / Q000648:ultrastructure; D004396:Coloring Agents; D004273:DNA, Neoplasm / Q000235:genetics*; D004171:Diploidy; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010166:Palliative Care; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D011003:Ploidies; D011379:Prognosis; D015996:Survival Rate
D004396:Coloring Agents; D004273:DNA, Neoplasm