DNA analysis of head and neck squamous cell carcinoma by flow cytometry

The use of flow cytometry to measure the DNA content from tumors has evolved over the years. In squamous cell carcinoma arising in the head and neck, there has not been uniform agreement in the literature, and decisions regarding patient treatment cannot be made using this parameter. The use of proliferating cell nuclear antigen (PCNA), a newly available marker of a cell's proliferative activity (S-phase fraction) is also discussed. In a prospective series of patients, the findings of diploidy, aneuploidy, low (PCNA) positivity, and high PCNA positivity are compared to known biological parameters. Strong trends are shown demonstrating biological aggressiveness associated with aneuploidy, high PCNA fraction, and the combination of aneuploidy and high PCNA fraction. The potential use of whole-cell preparation to determine ploidy and PCNA fraction as a predictor of metastatic potential are discussed. The whole-cell preparation technique allows accurate DNA ploidy measurements and, with the use of PCNA, a measure of proliferative activity. These parameters combined with known TNM staging may 1. allow alteration in treatment and ultimately affect patient survival, and 2. allow comparison of treatment modalities between biologically similar tumors.