Prognostic Significance of Ploidy and DNA Index in Patients with Epithelial Ovarian Carcinoma

Abstract

Objective: To explore the significance of DNA ploidy and DNA index cutt off value to overall survival, and their potential value as independent prognostic factors. Material and Methods: Paraffin-embedded tissue from sixty-one ovarian epithelial cancers were analyzed by histology and flow cytometry. The results of DNA analysis were correlated with clinicopathologic data. For univariate survival analysis we used the Kaplan-Meier model and log-rank test to assess the differences between the groups. For multivariate analysis, Cox proportional hazard regression model was used to examine several parameters simultaneously. Results: Aneuploidy was significantly associated with advanced clinical stage, menopausal status, high grade, serous histological type and vascular invasion. Univariate analysis showed that aneuploidy (p = 0.001) and DNA index > 1.4 (p = 0.007) were associated with shorter overall survival. Multivariate analysis showed only vascular invasion as an independent prognostic factor (p < 0.001). Conclusions: Although abnormal DNA content was associated with traditional clinicopathological characteristics for aggressive tumors and shorter overall survival, aneuploidy and high DNA index had no independent prognostic value in our study.

Zusammenfassung

Zielsetzung: Feststellung der Signifikanz der DNS-Ploidie und der DNS-Indizes für das Überleben von Ovarialkarzinom-Patientinnen und der potenziellen Bedeutung dieser Indizes als unabhängige prognostische Faktoren. Material und Methoden: Paraffiniertes Gewebe von 61 Ovarialkarzinomen wurde histologisch und mittels Durchflusszytometrie analysiert. Die Ergebnisse der DNS-Analysen wurden mit den klinisch-pathologischen Daten verglichen. Die Kaplan-Meier-Methode und der Log-Rank-Test wurden zur Bewertung der Überlebensanalyse und der Unterschiede zwischen den einzelnen Gruppen angewendet. Zur Multivarianzanalyse verwendeten wir das Cox'sche proportionale Zufalls-Regressionsmodell, um mehrere Parameter gleichzeitig messen zu können. Ergebnisse: Eine Aneuploidie bestand signifikant bei fortgeschrittenem klinischem Status, Menopause, bei hochgradiger Serohistologie und bei vaskulärer Tumorinvasion. Die Univarianzanalyse ergab, dass bei Aneuploidie (p = 0,001) und einem DNS-Index ≥1,4 (p = 0,007) die allgemeine Überlebensrate kürzer war. Die Multivarianzanalyse ergab lediglich die vaskuläre Tumorinvasion als unabhängigen Prognosefaktor (p < 0,001). Schlussfolgerung: Obwohl sich ein anormaler DNS-Gehalt als klinopathologisch charakteristisch für das Vorhandensein aggressiver Tumoren und eine kürzere Überlebenszeit erwies, ergaben sowohl Aneuploidie als auch ein hoher DNS-Index keinen unabhängigen prognostischen Wert im Rahmen unserer Untersuchung.

DNA Index - flow cytometry - ovarian cancer - ploidy

DNA‐Index - Flow‐Zytometrie - Ovarialkarzinom - Ploidie

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