Nuclear DNA Content and Progression of Human Gastric Cancer

本文对154例早期胃癌和100例进展期胃癌进行了细胞核DNA含量与肿瘤进展的相关性研究。Feulgen染色后用双波长显微分光光度法测定细胞核DNA含量，根据DNA直方图上的离散度将DNA分布模式分为低倍体和高倍体。低倍体肿瘤以未分化型胃癌为特征，高倍体肿瘤以分化型胃癌为特征，组织学上肿瘤细胞聚集性研究表明，未分化型胃癌中低倍体肿瘤以游离细胞型为特征，高倍体肿瘤以巢状细胞型为特征，随着肿瘤向深层浸润，高倍体肿瘤增多，未分化型胃癌中这一现象较分化型胃癌明显。在分化型胃癌中，15%（3/20）和3%（3/20）的胃癌组织中存在DNA异倍性，表现为粘膜层低倍性，而深层高倍性。 关于我们 在未分化癌中为0%（6/20）。高倍体组淋巴结转移率高于低倍体组。60.7%（37/67）的淋巴结转移灶DNA含量在直方图上较原发灶DNA含量离散度小，即“倍体减少”，这可能与宿主的防御机制有关。高倍体组的5年生存率为73.7%，低倍体组为90.6%，两者差异有统计学意义（P < 0.05），仅在有转移组差异有统计学意义（P < 0.05）。多因素分析表明，DNA分型是独立的预后因素。与化疗有关，高倍体胃癌对丝裂霉素C、阿克拉霉素和卡波醌的敏感性较高，提示DNA倍体与胃癌的进展和预后密切相关。高倍体肿瘤的化疗敏感性也很高，并提出了DNA倍体的治疗应用。少

Correlation between the tumor progression and nuclear DNA content was studied in the 154 early and 100 advanced human gastric cancers. Nuclear DNA content was determined by microspectrophotometry using two-wavelength method after Feulgen staining, and the DNA distribution patterns were divided into low and high ploidies according to the dispersion on the DNA histogram. Low ploidy tumors were characterized by undifferentiated type gastric cancers and high ploidy by differentiated ones.In the undifferentiated type, low ploidy were characterized by free-cell type and high ploidy by nest-forming type from the study of tumor cell aggregation, histologically.High ploidy tumors increased as tumors invaded into deeper layers, and this phenomenon was obvious in the undifferentiated type gastric cancers compared with differentiated ones. Heterogeneity of DNA pattern, which indicated low ploidy in the mucosa, but high ploidy in deeper layers, was observed in 15% (3/20) in the differentiated and 3 … More 0% (6/20) in the undifferentiated carcinomas. There was a high incidence of lymph node metastasis in the high ploidy group, compared with the low ploidy group. DNA content of metastatic foci in the lymph node showed narrower dispersion on the histogram than that of primary lesion, "Ploidy Reduction", in 60.7% (37/67), and this phenomenon was thought to be attributed to the host defense mechanism. The 5-year survival rate was 73.7% in patient with high ploidy, with a statistical difference compared to the 90.6% in those of low ploidy and the difference in the survival rate was significant only in those with a metastasis. Further more, from the multivariate analysis, DNA pattern was proved to be an independent prognostic factor. In relation to chemotherapy, high ploidy tumors showed higher chemosensitivity to Mitomycin C, Aclasinomycin, and Carboquone.These findings indicate a close correlation between DNA ploidy and progression and prognosis of human gastric cancer. High chemosensitivity of high ploidy tumors was also shown and the therapeutic application of DNA ploidy was proposed. Less