Methodology and clinical applications of cellular DNA content parameters determined by flow cytometry in squamous cell cancers of the head and neck.
Methodology and clinical applications of cellular DNA content parameters determined by flow cytometry in squamous cell cancers of the head and neck.
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流式细胞术测定头颈鳞状细胞癌细胞 DNA 含量参数的方法学和临床应用。
DOI：
10.1007/978-1-4613-1499-8_14
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发表时间：
1990
影响因子：
--
通讯作者：
Sakr,W
中科院分区：
文献类型：
--
作者：
Ensley,JF;Maciorowski,Z;Pietraszkiewicz,H;deBraud,F;Sakr,W
大多数头颈部鳞状细胞癌（SCCHN）患者存在无法治愈或复发的疾病，并且许多治愈的患者由于常规治疗而获得不可接受的功能和美容缺陷[1，2]。有效的细胞毒性治疗方案可能最终治愈晚期患者，并预防复发，减少早期患者常规治疗的不良后果[3-5]。据报道，晚期肿瘤的总体缓解率和完全缓解率（CR）分别为80-90%和35-54%[1]。最近在使用强化化疗或同步放化疗的试点试验中描述了CR率超过80%[6-7]。达到临床CR的患者表现出生存优势[1-5]，这在治疗导致显微镜下疾病根除时尤为明显[8]。然而，在初始治疗后，50%的患者达到不到CR，并且50%的CR与残留的显微镜下病变相关。具有相似肿瘤负荷并且在其他重要临床特征方面具有可比性的患者在治疗结果方面可能存在很大差异。单独的临床和形态学参数不足以作为常规治疗[8]以及细胞毒性治疗[9-12]后治疗结局的预测因子。这对于个体患者尤其如此，即使在最晚期（N3淋巴结状态）也非常明显，其中高达30%的患者可以通过细胞毒性治疗达到CR [1-4]。预测治疗后临床结局的能力将允许：（a）更好地对临床试验进行分层，（B）适当选择I期、II期和某些III期患者进行辅助细胞毒性试验，（c）为预期耐药或耐药的晚期肿瘤设计更有效的细胞毒性方案，（d）降低非常有效的晚期肿瘤的细胞毒性方案强度，以及（e）在临床和实验水平上研究缓解和耐药[9，10]。细胞DNA含量参数已成为血液恶性肿瘤和少数实体瘤的重要预后指标[13]。最常从DNA直方图确定的DNA含量参数是DNA指数（DI），其比较细胞的DNA含量。
Most patients with squamous cell carcinomas of the head and neck (SCCHN) present with incurable or recurrent disease, and many who are cured acquire unacceptable functional and cosmetic deficits as a consequence of conventional therapy [1, 2]. Effective cytotoxic treatment regimens may eventually cure patients in advanced stages as well as prevent recurrences and reduce the undesirable consequences of conventional therapy in patients with earlier stages [3-5]. Overall and complete response (CR) rates in the range of 80-90% and 35-54% respectively, have been reported in advanced tumors [1]. CR rates above 80% have been described recently in pilot trials using intensive chemotherapy or concurrent chemo-radiotherapy [6-7]. Patients achieving clinical CR demonstrate survival advantages [1-5] which are particularly evident when therapy results in the eradication of microscopic disease [8]. Nevertheless, following initial treatment, 50% of the patients achieve less than a CR, and 50% of the CRs are associated with residual microscopic disease.Patients who have similar tumor burdens and are comparable in terms of other important clinical features may differ widely in terms of treatment outcome. Clinical and morphological parameters alone are inadequate as predictors of treatment outcome following conventional [8] as well as cytotoxic therapy [9-12]. This is particularly true for an individual patient and very evident in even the most advanced stage (N3 lymph node status) where up to 30% of these patients may achieve a CR with cytotoxic therapy [1-4]. The ability to predict the clinical outcome following therapy would allow:(a) better stratification of clinical trials,(b) the proper selection of stage I, II and certain stage III patients for adjuvant cytotoxic trials,(c) the design of more effective cytotoxic regimens for advanced tumors that are expected to be or become resistant,(d) the reduction of cytotoxic regimen intensity for advanced tumors that are very responsive, and (e) the study of response and resistance at the clinical and experimental level [9, 10]. Cellular DNA content parameters have become important as prognostic indicators for hematological malignancies and a few solid tumors [13]. The DNA content parameter most commonly determined from DNA histograms is the DNA Index (DI) which compares the cellular DNA content of a