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DNA ploidy of primary and metastatic squamous cell head and neck cancers
D L Burgio1, J R Jacobs, Z Maciorowski
1Department of Otolaryngology, Wayne State University, Detroit, MI 48201.
Abstract:
Regional metastases are a major determinant in the treatment outcome of patients with squamous cell carcinoma of the head and neck. Metastases do not respond as well to cytotoxic therapy as do primary tumors. DNA diploid tumors or tumor components also respond poorly to intermittent cytotoxic therapy. In our series of 497 patients with squamous cell carcinoma of the head and neck, the percentage of pure DNA diploid tumors and the mean DNA indexes in 497 primary tumors and 82 regional metastases were 34% and 1.54 and 50% and 1.34, respectively. Paired comparisons were performed in 61 patients and revealed a statistically significant increase in the frequency of DNA diploid tumors (27.4% to 41.2%) in associated lymph node metastases. The clinical observation that patients with squamous cell carcinoma of the head and neck and regional lymph node metastases have a poorer prognosis and a poorer response to cytotoxic therapy may in part be explained by the increased incidence of DNA diploid tumors in their regional lymph nodes, and the poorer response of such tumors to cytotoxic therapy.
Insights
Regional metastases in head and neck squamous cell carcinoma are often DNA diploid, responding poorly to chemotherapy. This study found a higher incidence of DNA diploid tumors in lymph node metastases, explaining poorer patient outcomes.
Area of Science:
- Oncology
- Cancer Biology
- Genetics
Background:
- Regional metastases significantly impact treatment outcomes for head and neck squamous cell carcinoma (HNSCC).
- Metastatic tumors and DNA diploid tumors exhibit reduced sensitivity to cytotoxic therapies.
- Understanding the DNA content of primary tumors versus metastases is crucial for treatment stratification.
Purpose of the Study:
- To investigate the DNA ploidy status of primary HNSCC tumors and their regional lymph node metastases.
- To correlate DNA ploidy with treatment response and patient prognosis in HNSCC.
Main Methods:
- Analysis of DNA content (ploidy) in 497 primary HNSCC tumors and 82 regional lymph node metastases using flow cytometry.
- Paired comparison of DNA ploidy in 61 patients with primary tumors and associated lymph node metastases.
Main Results:
- 34% of primary HNSCC tumors were DNA diploid, with a mean DNA index of 1.54.
- 50% of regional metastases were DNA diploid, with a mean DNA index of 1.34.
- A significant increase in DNA diploid tumors was observed in lymph node metastases (27.4% to 41.2%) compared to primary tumors.
Conclusions:
- The increased incidence of DNA diploid tumors in regional lymph node metastases of HNSCC may contribute to poorer patient prognosis.
- The poor response of DNA diploid tumors to cytotoxic therapy, coupled with their higher frequency in metastases, explains the observed clinical outcomes.