PROGNOSTIC VALUE OF FLOW CYTOMETRIC DNA ANEUPLOIDY AND HIGH SYNTHESIS PHASE FRACTION IN PRIMARY BREAST CANCER
NÜVIT DURAKER1, ELIF PEŞTERELİ3, SINAN ÇAVUŞOĞLU3, ÖMER BENDER1, DENIZ ÖZCAN2, ÖZDEN ÖZCALAY4
1SSK Okmeydanı Hastanesi, 3. Genel Cerrahi Kliniği, İSTANBUL
2SSK Okmeydanı Hastanesi, Patoloji Kliniği, İSTANBUL
3SSK Okmeydanı Hastanesi, Pakize Tarzi Kliniği, İSTANBUL
4Cerrahpaşa Tıp Fakültesi Biyoistatistik Bilim Dalı, İSTANBUL
In order to detect the significance of DNA ploidy and S-phase fraction in primary breast cancer, cells from archival paraffin embedded tumor tissue taken from 66 patients who underwent surgery between 1987 and 1990 were analyzed for flow cytometry. Mean follow up of 42 cases who had no recurrences was 59.6 months. Diploidy was found in 27 (40.9%), aneuploidy in 39 (59.1%) of the tumors. Prognostic factors such as patient's age, tumor size, state of menopause, histologic grade and axillary nodal involvement did not correlate with ploidy. SPF was 14.9 and 14.6 in diploidy and aneuploidy groups respectively. The patients who had greater SPF values than mentioned levels has been considered high SPF group. Although a significant correlation was not obtained between SPF and other factors, lower SPF values obtained in well differentiated tumors than moderately or poorly differentiated ones (p=0.064). In the univariate analysis disease-free survival (DPS) was significantly high in axillary node negative tumors, in tumors 2cm and smaller, and in well differentiated tumors (p=0.005, p=0.031 and p=0.035 respectively). Despite a significant correlation was not found between ploidy and DPS, in the low SPF group DPS was better than those high SPF group but the difference was not significant (p=0.111). In diploid tumors DPS of low SPF group was better than those high SPF however the difference was not within the limits of significance (p=0.093). In multivariated Cox regression test only independent factor was axillary nodal involvement (p =0.022). Secondly SPF appeared to preserve the degree of significance (p=0.118).
As a conclusion in detecting prognostic significance, although DNA ploidy by flow cytometry is not sufficient, SPF may play a major role, but this factor should be considered with other factors in determining the mode of therapy until more precise data are available.
Keywords: FLOW CYTOMETRY, DNA CONTENT, SYNTHESIS PHASE, DISEASE-FREE SURVIVAL