[Clinicopathological study on the proliferation and differentiation of laryngeal carcinoma and dysplasia]

It is important to examine the proliferative activity of cells in the laryngeal carcinoma and dysplasia for the decision of the clinical treatment and the presumption of the prognosis. I studied here the proliferative activity with three indications, such as the measurement of nuclear DNA contents by flow cytometry, immunohistochemistry of Proliferating Cell Nuclear Antigen (PCNA) and intake of bromodeoxyuridine (BrdU). Furthermore, I compared the proliferative activity with cellular differentiation, which was investigated by immunohistochemistry of involucrin, a marker of human mature suprabasal squamous epithelia. Flow cytometric DNA analysis was performed in 69 patients of laryngeal carcinoma and in 15 patients of dysplasia. In laryngeal carcinoma, 41 cases (59%) had DNA aneuploid pattern, and in dysplasia, 6 cases (40%) represented aneuploid group, and 27% and 11% per 1 hour in diploid group, respectively. The mean of DNA Index (DI) was 1.21 in the carcinoma and 1.13 in the dysplasia. In the cases of recurrent carcinoma and transformed carcinoma, aneuploid pattern was predominant and DI was high. I performed double staining of BrdU and involucrin in these cases. The former is an index of cellular proliferation and the latter is a marker of the differentiation, as described above. These two markers showed reciprocal relationship in normal squamous cell layers, dysplasia and many areas of squamous cell carcinoma. But, some cells of the carcinoma in advanced stage represented concomitantly positive result in these two markers. This finding suggests the biological disorder in these carcinoma cells and requires the follow-up examination of these cases.