Prediction of recurrence or metastasis of malignant tumors by assessment of their growth abilities and its clinical application

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It was recently demonstrated that proliferative activity is prognostically more significant than DNA ploidy petterns. The proliferative status of tumor cells has been roughly determined by several factors, including the mitotic index, S-phase fraction, labeling index and tumor colony formation. However, those fasctors have been fegarded as being less important than tumor staging. Advances in tissue culture techniques ha have made it possible for cells from fresh solid tumors to proliferate in semisolid medium. In a thymidine incorporation assay, which we originally developed, it is possible to measure the incorporation of tritiated thymidine by tumor cells. The scope of this study is to evaluate the clonicopathological correlations and the prognostic value of tritiated thymidine uptake in gastric and colorectal cancer patients.In 173 patients with operable gastric cancer and in 127 patients with colorectal carcinoma, thymidine uptake by tumor cells cultured in a semi solid medium was medsured and was compared the influence of various parameters on survival by**ivariate and multivariate analysis. Patients in the high-uptake had a poorerprognosis than those in the low-uptake, both with gastric and colorectal cancer. Mulativariate analysis showed that thymidine uptake was one of the variables strongly associated with survival in our study population with gastric or colorectal carcinoma. Thus, it is concluded that thymidine uptake by tumor cells is an independent prognostic indicator which may be useful for selecting patients with gastric and colorectal carcinoma who wouldbenetil from more aggressive treatment.