DNA ploidy as a prognostic factor in early esophageal carcinoma

Cell nuclear DNA content was cytophotometrically determined in biopsy specimens obtained from thirty-five patients with superficial esophageal carcinoma. The relationship between the DNA distribution pattern and histopathological features, prognosis and postoperative survival time was then investigated. Patients with a low ploidy pattern had a more favorable postoperative course, with 62% attaining a 5-year survival rate, than those with high ploidy, of whom 34% attained a 5-year survival rate (p < 0.01). The recurrence rate was higher for the high ploidy pattern (64.3%) than for the low ploidy pattern (35.3%). Moreover, the rate of recurrence within 2 years was 50% in high ploidy, which was higher than the 5.9% rate in the case of low ploidy (p < 0.05). Although there was no clearly established relationship between the DNA distribution pattern and clinicopathological features, a multivariate analysis revealed that the DNA distribution pattern was one of the independent and significant prognostic factors of superficial esophageal carcinoma. These results thus suggest the usefulness of a preoperative DNA analysis of biopsy specimens in predicting the prognosis and determining perioperative therapeutic strategy for both superficial esophageal carcinoma and for advanced cases.