DNA ploidy and S-phase fraction as prognostic factors in surgically resected gastric carcinoma: a 7-year prospective study.
BACKGROUND
DNA ploidy and S-phase fraction (SPF) measured by DNA flow cytometry (FC) have been previously shown to correlate with several clinicopathological variables in several types of tumours.


METHODS
DNA FC was performed on multiple frozen tumour samples obtained from 115 patients undergoing curative surgery for gastric cancer (GC). The findings were prospectively tested for correlation with traditional clinicopathological indicators of prognosis.


RESULTS
Overall, 20 tumours (17.4%) were diploid, 46 (40.0%) monoclonal and 49 (42.6%) multiclonal. Excluding 4 patients who died within 1 month of surgery, high SPF (>9.6%) was detected in 55 patients (49.6%) and was found to be significantly associated with vascular invasion and multiclonality (p=0.02). An association of borderline statistical significance emerged with macroscopic type (p=0.06) and pN and pM status (p=0.07). Multivariate regression analysis did not show a significant effect of SPF (p=0.11) or DNA ploidy (p=0.28) on 7-year survival.


CONCLUSIONS
Aneuploidy appears to be a prognostic factor of low penetrance, whereas SPF is a more promising parameter of tumour aggressiveness in patients with GC.
Nesi
Gabriella
G
Department of Human Pathology and Oncology, University of Florence, Florence, Italy. gabriella.nesi@unifi.it
Bruno
Lorenzo
L
Saieva
Calogero
C
Caldini
Anna
A
Girardi
Lucia Roberta
LR
Zanna
Ines
I
Rapi
Stefano
S
Bechi
Paolo
P
Cortesini
Camillo
C
Palli
Domenico
D
D000368:Aged; D005260:Female; D005434:Flow Cytometry; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011003:Ploidies; D011379:Prognosis; D016196:S Phase; D013274:Stomach Neoplasms / Q000235:genetics* / Q000401:mortality* / Q000601:surgery