title: Gross genomic damage measured by DNA image cytometry independently predicts gastric cancer patient survival.
abstract: BACKGROUND
  DNA aneuploidy reflects gross genomic changes. It can be measured by flow cytometry (FCM-DNA) or image cytometry (ICM-DNA). In gastric cancer, the prevalence of DNA aneuploidy has been reported to range from 27 to 100%, with conflicting associations with clinicopathological variables. The aim of our study was to compare the DNA ploidy status measured using FCM-DNA and ICM-DNA in gastric cancer and to evaluate its association with clinicopathological variables.
  
  
  METHODS
  Cell nuclei were isolated from 221 formalin-fixed, paraffin-embedded gastric cancer samples. DNA ploidy was assessed using FCM-DNA and ICM-DNA.
  
  
  RESULTS
  A total of 178 (80.5%) gastric cancer samples were classified as DNA aneuploid using FCM-DNA, compared with 172 (77.8%) gastric cancer samples when using ICM-DNA. Results obtained from both methods were concordant in 183 (82.8%) cases (kappa=0.48). Patients with ICM-DNA diploid gastric cancer survived significantly longer than those with ICM-DNA aneuploid gastric cancer (log rank 10.1, P=0.001). For FCM-DNA data, this difference did not reach statistical significance. The multivariate Cox model showed that ICM-DNA ploidy status predicted patient survival independently of tumour-node-metastasis status.
  
  
  CONCLUSIONS
  ICM-DNA ploidy status is an independent predictor of survival in gastric cancer patients and may therefore be a more clinically relevant read out of gross genomic damage than FCM-DNA.
authors.affiliation: Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands. jam.belien@vumc.nl
authors.forename: J A M
authors.initials: JA
authors.lastname: Belien
authors.forename: T E
authors.initials: TE
authors.lastname: Buffart
authors.forename: A J
authors.initials: AJ
authors.lastname: Gill
authors.forename: M A M
authors.initials: MA
authors.lastname: Broeckaert
authors.forename: P
authors.initials: P
authors.lastname: Quirke
authors.forename: G A
authors.initials: GA
authors.lastname: Meijer
authors.forename: H I
authors.initials: HI
authors.lastname: Grabsch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000782:Aneuploidy; D004273:DNA, Neoplasm / Q000032:analysis*; D005260:Female; D006801:Humans; D019044:Image Cytometry / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011003:Ploidies; D013274:Stomach Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology
chemical_list: D004273:DNA, Neoplasm