COMBINATION OF FLOW CYTOMETRIC DNA INDEX AND SYNTHESIS PHASE FRACTION HAVE AN INDEPENDENT PROGNOSTIC IMPORTANCE IN BREAST CANCER
NÜVİT DURAKER1, BAYRAM KAYA1, ÖZDEN ÖZ CALAY2
1SSK Okmeydanı Eğitim Hastanesi, 3. Cerrahi Kliniği, İSTANBUL
2İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Biyoistatistik Bilim Dalı, İSTANBUL
In order to detect the prognostic value of combination of flow cytometric DNA index (Di) and synthesis phase fraction (SPF) in breast cancer, cells from archival paraffin embedded tumor tissues of 78 patients were examined. in the aneuploid group (DI>1) the mean Di was 1.72. The mean SPF values of both aneuploid and diploid groups were calculated separately and patients in both groups were categorized as with low versus high SPF values. Two combination models were formed with Di and SPF assuming to be able to categorize patients into good versus poor prognostic groups. In model A, patients in good prognostic group were considered with Dl=1 and with low SPF values; whereas patients in poor prognostic group were regarded with Dl>1 and with high SPF values. in model B, while the criteria for good prognostic group did not change, patients with DI> 1.72 and high SPF values were high in the patients with tumors 2 cm and smaller and in axillary node negative tumors, whereas Di and SPF did not effect the prognosis. In model A there was no prognostic difference between groups, however in model B,disease-free survival was 85.7 months versus 42.9 months (p=0.016)in good versus poor prognostic groups respectively. In multivariated Cox regression analysis besides the tumor size 8 model had independent prognostic significance (p=0.04). In conclusion in breast cancer Di and SPF separately do not have a prognostic value, however their combination has an independent prognostic importance, and patients can be divided into low and high risk groups according to this combination.
Keywords: BREAST CARCINOMA, DNA INDEX, SYNTHESIS PHASE, DISEASE-FREE SURVIVAL