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DNA content by flow cytometry in gastric carcinoma: pathology, ploidy and prognosis
F Esteban1, D S de Vega, R Garcia
1Hospital Universitario San Carlos, Department of Surgery, Madrid, Spain.
Background/Aims:
The prognostic relevance of histopathologic findings in gastric carcinoma is well established. Studies on DNA-ploidy are still scanty and contradictory.
Methodology:
Histopathologic parameters, DNA ploidy and S-phase were evaluated in 78 cancer patients curatively resected, using formalin-fixed paraffin-embedded tissue.
Results:
Thirty-nine tumors (50%) were aneuploid. No significant correlation was found between histologic data and ploidy, but tumors with nodal involvement were more frequently aneuploid. In univariate analysis, tumor location (p=0.05), tumor size (p=0.01), differentiation grade (p=0.02), Lauren classification (p=0.01), deeper infiltration of gastric wall (p=0.001), nodal affectation (p=0.0000) and number of lymph nodes (p=0.01), TNM stage (p=0.0000), type of gastrectomy performed (p=0.04), and DNA ploidy (p=0.04) significantly influenced survival. S-phase values had no effect on prognosis. In the multiple regression model, factors independently associated with survival were TNM stage (p=0.0009), nodal affectation (p=0.01) and, marginally, ploidy (p=0.08).
Conclusions:
In gastric carcinoma curatively resected, the more relevant prognostic factors were stage and nodal involvement. Fifty percent of the tumors were aneuploid. Aneuploidy was significantly associated with poorer prognosis.