Nuclear DNA Content and Progression of Human Gastric Cancer

研究了154例早期胃癌和100例晚期胃癌的肿瘤进展与细胞核DNA含量的关系。Feulgen染色后，采用双波长显微分光光度法测定细胞核DNA含量，并根据DNA直方图上的分散度将DNA分布模式分为低倍体和高倍体。低倍性肿瘤以未分化型胃癌为特征，高倍性肿瘤以分化型胃癌为特征。在未分化型中，低倍性表现为自由细胞型，高倍性表现为巢型。高倍体肿瘤随着肿瘤向更深层的浸润而增加，这种现象在未分化型胃癌中较分化型胃癌更为明显。DNA模式的异质性表现为粘膜低倍性，深层高倍性，分化癌中有15%（3/20）倍性，未分化癌中有3%（6/20）倍性。高倍性组淋巴结转移发生率高于低倍性组。淋巴结转移灶的DNA含量在直方图上比原发病灶“倍性降低”（Ploidy Reduction）的DNA含量分散窄，为60.7%(37/67)，这一现象被认为与宿主防御机制有关。高倍性患者的5年生存率为73.7%，与低倍性患者的90.6%有统计学差异，仅转移者的5年生存率差异有统计学意义。此外，从多变量分析中，DNA模式被证明是一个独立的预后因素。与化疗相关，高倍体肿瘤对丝裂霉素C、阿克拉霉素和卡喹酮具有较高的化疗敏感性。这些发现提示DNA倍体与人胃癌的进展和预后密切相关。高倍性肿瘤也显示出高的化学敏感性，并提出了DNA倍性的治疗应用。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