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[Fluorocytometric DNA analysis of borderline lesions in the large intestine]
Abstract:
A total of 9 surgically resected non-cancerous benign lesions (5 regenerative epithelium, 4 hyperplastic or metaplastic epithelium), 4 normal epithelium, 30 carcinomas and 12 adenomas containing 7 moderate dysplastic epithelium and 5 severe dysplastic epithelium in the large intestine, were used. Then 40 microns thick paraffin sections were made from each specimen, dewaxed, and the target portion was excised under microscopic visualization. Free cells isolated by 0.5% pepsin solution were smeared and followed by DNA staining by DAPI, and fluorocytometric DNA measurement was performed using a fluorocytometer (BH 2.QRFL, Olympus). All specimens of non-cancerous benign epithelium and normal epithelium showed diploidy. The average mean DNA value was 2.03 +/- 0.04 c (1.95-2.10), the percentage of cells above 4.1 c (4.1 c > or = %) averaged 0.26 +/- 0.42% (0-1.25) and the coefficient of variation (CV) averaged 14.30 +/- 3.18% (10.19-19.58). Seven of 30 carcinomas showed diploidy. Among these diploid carcinomas, the mean DNA value averaged 2.30 +/- 1.98 c (2.01-2.71) (p < 0.05), 4.1 c > or = % averaged 4.17 +/- 2.91% (2.0-10.5) (p < 0.05) and CV averaged 32.2 +/- 5.8% (24.43-38.90) (p < 0.01). Based on these results, aneuploid cases were judged to be malignant. In the case of diploidy, if the percentage of cells above 4.1 c was more than 2.0% and CV was more than 24.43%; when the former was less than 1.25% and the latter was less than 19.58%; and when one or both of the two was out of the range described in the above two categories, they were judged to be malignant, benign or borderline, respectively. From these criteria, 7 adenomas showing moderate dysplasia were analyzed as benign in 2, borderline in 4 and malignant in 1, while 5 adenomas evidencing severe dysplasia were analyzed as malignant in 4 and borderline in 1. In conclusion, fluorocytometric evaluation of the malignant or benign tumor of borderline lesions in the large intestine was found to be possible.