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Patra S, Naik PP, Mahapatra KK, Alotaibi MR, Patil S, Patro BS, Sethi G, Efferth T, Bhutia SK. Recent advancement of autophagy in polyploid giant cancer cells and its interconnection with senescence and stemness for therapeutic opportunities. Cancer Lett 2024; 590:216843. [PMID: 38579893 DOI: 10.1016/j.canlet.2024.216843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/11/2024] [Accepted: 04/01/2024] [Indexed: 04/07/2024]
Abstract
Recurrent chemotherapy-induced senescence and resistance are attributed to the polyploidization of cancer cells that involve genomic instability and poor prognosis due to their unique form of cellular plasticity. Autophagy, a pre-dominant cell survival mechanism, is crucial during carcinogenesis and chemotherapeutic stress, favouring polyploidization. The selective autophagic degradation of essential proteins associated with cell cycle progression checkpoints deregulate mitosis fidelity and genomic integrity, imparting polyploidization of cancer cells. In connection with cytokinesis failure and endoreduplication, autophagy promotes the formation, maintenance, and generation of the progeny of polyploid giant cancer cells. The polyploid cancer cells embark on autophagy-guarded elevation in the expression of stem cell markers, along with triggered epithelial and mesenchymal transition and senescence. The senescent polyploid escapers represent a high autophagic index than the polyploid progeny, suggesting regaining autophagy induction and subsequent autophagic degradation, which is essential for escaping from senescence/polyploidy, leading to a higher proliferative phenotypic progeny. This review documents the various causes of polyploidy and its consequences in cancer with relevance to autophagy modulation and its targeting for therapeutic intervention as a novel therapeutic strategy for personalized and precision medicine.
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Affiliation(s)
- Srimanta Patra
- Cancer and Cell Death Laboratory, Department of Life Science, National Institute of Technology Rourkela, Rourkela, 769008, Odisha, India
| | - Prajna Paramita Naik
- Cancer and Cell Death Laboratory, Department of Life Science, National Institute of Technology Rourkela, Rourkela, 769008, Odisha, India; Department of Zoology Panchayat College, Bargarh, 768028, Odisha, India
| | - Kewal Kumar Mahapatra
- Cancer and Cell Death Laboratory, Department of Life Science, National Institute of Technology Rourkela, Rourkela, 769008, Odisha, India; Department of Agriculture and Allied Sciences (Zoology), C. V. Raman Global University, Bhubaneswar, 752054, Odisha, India
| | - Moureq Rashed Alotaibi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Shankargouda Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, 84095, USA
| | - Birija Sankar Patro
- Chemical Biology Section, Bio-Organic Division, Bhabha Atomic Research Centre, Mumbai, 400085, India
| | - Gautam Sethi
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, 117600, Singapore
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, 55128, Mainz, Germany
| | - Sujit Kumar Bhutia
- Cancer and Cell Death Laboratory, Department of Life Science, National Institute of Technology Rourkela, Rourkela, 769008, Odisha, India.
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Hemida AS, Taie DM, El-Wahed MMA, Shabaan MI, Tantawy MS, Ehsan NA. EpCAM, Ki67, and ESM1 Predict Hepatocellular Carcinoma Recurrence After Liver Transplantation. Appl Immunohistochem Mol Morphol 2023; 31:596-606. [PMID: 37668411 DOI: 10.1097/pai.0000000000001150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 08/01/2023] [Indexed: 09/06/2023]
Abstract
Liver transplantation (LT) is a good therapeutic decision, cures hepatocellular carcinoma (HCC) and promotes survival of cases with unrespectable HCC based on the Milan criteria. HCC still recur after LT. Identifying high risk tissue markers that predict recurrence becomes important for LT decision-making. Little is known regarding use of tissue expression of epithelial cell adhesion molecule (EpCAM) to predict HCC recurrence. This study investigates the role of EpCAM, Ki67, and endothelial-cell-specific molecule-1 (ESM1) as immunohistochemical markers to predict HCC recurrence after LT. It included 52 explanted HCC tissues from Egyptian patients who had undergone LT for HCC according to Milan criteria. Immunohistochemical staining was done on paraffin-embedded formalin-fixed tissue sections. HCC recurrence occurred in 13.5% cases. Positive EpCAM expression in HCC, was significantly associated with HCC recurrence, ( P =0.011), achieving 71.43% sensitivity, 84.44% specificity and 78.8% accuracy in predicting recurrence. High Ki67 percentage was significantly associated with HCC recurrence, ( P =0.005), achieving 57.14% sensitivity, 86.67% specificity and 82.69% accuracy in predicting HCC recurrence. ESM1 showed significant association with HCC recurrence ( P =0.041), with 71.43% sensitivity, 71.11% specificity and 71.15% accuracy in predicting HCC recurrence. EpCAM score and Ki67 percentage showed positive correlation. In conclusion, it is suggested that large tumor size (≥3 cm), advanced pathologic staging and Ki67 could be stratified as high risk predictors of HCC recurrence after LT. Although higher classes of Child-Turcotte-Pugh classification, high serum alpha-fetoprotein, microvascular invasion, positive EpCAM and ESM1 are stratified as lower risk predictors of HCC recurrence after LT.
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Affiliation(s)
| | - Doha Maher Taie
- Department of Pathology, National Liver Institute, Menoufia University, Shebin El Kom, Egypt
| | | | | | - Mona Saeed Tantawy
- Department of Pathology, National Liver Institute, Menoufia University, Shebin El Kom, Egypt
| | - Nermine Ahmed Ehsan
- Department of Pathology, National Liver Institute, Menoufia University, Shebin El Kom, Egypt
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3
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Nassar AH, Mouw KW, Jegede O, Shinagare AB, Kim J, Liu CJ, Pomerantz M, Harshman LC, Van Allen EM, Wei XX, McGregor B, Choudhury AD, Preston MA, Dong F, Signoretti S, Lindeman NI, Bellmunt J, Choueiri TK, Sonpavde G, Kwiatkowski DJ. A model combining clinical and genomic factors to predict response to PD-1/PD-L1 blockade in advanced urothelial carcinoma. Br J Cancer 2019; 122:555-563. [PMID: 31857723 PMCID: PMC7028947 DOI: 10.1038/s41416-019-0686-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/25/2019] [Accepted: 10/08/2019] [Indexed: 12/12/2022] Open
Abstract
Background In metastatic urothelial carcinoma (mUC), predictive biomarkers that correlate with response to immune checkpoint inhibitors (ICIs) are lacking. Here, we interrogated genomic and clinical features associated with response to ICIs in mUC. Methods Sixty two mUC patients treated with ICI who had targeted tumour sequencing were studied. We examined associations between candidate biomarkers and clinical benefit (CB, any objective reduction in tumour size) versus no clinical benefit (NCB, no change or objective increase in tumour size). Both univariable and multivariable analyses for associations were conducted. A comparator cohort of 39 mUC patients treated with taxanes was analysed by using the same methodology. Results Nine clinical and seven genomic factors correlated with clinical outcomes in univariable analysis in the ICI cohort. Among the 16 factors, neutrophil-to-lymphocyte ratio (NLR) ≥5 (OR = 0.12, 95% CI, 0.01–1.15), visceral metastasis (OR = 0.05, 95% CI, 0.01–0.43) and single-nucleotide variant (SNV) count < 10 (OR = 0.04, 95% CI, 0.006–0.27) were identified as independent predictors of NCB to ICI in multivariable analysis (c-statistic = 0.90). None of the 16 variables were associated with clinical benefit in the taxane cohort. Conclusions This three-factor model includes genomic (SNV count >9) and clinical (NLR <5, lack of visceral metastasis) variables predictive for benefit to ICI but not taxane therapy for mUC. External validation of these hypothesis-generating results is warranted to enable use in routine clinical care.
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Affiliation(s)
- Amin H Nassar
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Kent W Mouw
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Opeyemi Jegede
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Atul B Shinagare
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Jaegil Kim
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Chia-Jen Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Mark Pomerantz
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Lauren C Harshman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Eliezer M Van Allen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Xiao X Wei
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Bradley McGregor
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Atish D Choudhury
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Mark A Preston
- Division of Urology, Brigham and Women's Hospital, Boston, MA, USA
| | - Fei Dong
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - Sabina Signoretti
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Department of Oncologic Pathology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Neal I Lindeman
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - Joaquim Bellmunt
- Department of Medical Oncology, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Toni K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Guru Sonpavde
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
| | - David J Kwiatkowski
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. .,Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
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Silvestrini R, Daidone MG, Costa A. Cell Kinetics of Solid Tumors with Time and Its Clinical Implication. TUMORI JOURNAL 2018; 75:367-72. [PMID: 2815344 DOI: 10.1177/030089168907500413] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The proliferative rate has been evaluated for several human tumor types as the fraction of cells in S-phase. The methodologies most often used are autoradiographic determination of 3H-thymidine incorporation and flow cytometric evaluation of DNA content. Cell kinetics determined on various solid primary tumors at the time of diagnosis is not related to pathologic stage but it is an indicator of clinical evolution of the disease similar or superior to other biologic and pathologic prognostic factors. In early disease, submitted to loco-regional treatment as a first-line therapy, the rate of cell proliferation provides prognostic information on relapse-free and overall survival. In this clinical situation, a different metastatic potential can be attributed to tumors with different proliferative rates. In more extensive disease, submitted to systemic treatment, proliferation indices generally influence overall survival, eventhough in responsive tumors a fast proliferative activity could be indicative of higher aggressiveness and remarkable chemosensitiveness. Proliferation indices of the metachronous metastatic lesions is increased over those of the primary tumors as a further evidence of the association between proliferative activity and disease progression.
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Affiliation(s)
- R Silvestrini
- Oncologia Sperimentale C, Istituto Nazionale Tumori, Milan, Italy
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Giaretti W. Ploidy and Proliferation Evaluated by Flow Cytometry. An Overview of Techniques and Impact in Oncology. TUMORI JOURNAL 2018; 77:403-19. [PMID: 1838217 DOI: 10.1177/030089169107700508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Flow cytometric methods for the assessment of nuclear and chromosomal DNA content and of cell proliferation (including methods based on pulse-chase of bromodeoxyuridine and on monoclonal antibodies against nuclear oncoproteins and proliferation-associated antigens) are illustrated by examples and analyzed critically. The impact of most of these techniques for the study of human solid tumors, with exception of nuclear DNA content evaluation, appears still limited. In particular, new studies of cell lines and clinical material from human tumors using new proliferation markers and multiparameter flow cytometry are necessary to solve a considerable number of methodologic and scientific problems.
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Affiliation(s)
- W Giaretti
- Laboratorio di Biofisica e Citometria, Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
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Davoli T, Uno H, Wooten EC, Elledge SJ. Tumor aneuploidy correlates with markers of immune evasion and with reduced response to immunotherapy. Science 2017; 355:355/6322/eaaf8399. [PMID: 28104840 DOI: 10.1126/science.aaf8399] [Citation(s) in RCA: 837] [Impact Index Per Article: 119.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 12/16/2016] [Indexed: 12/18/2022]
Abstract
Immunotherapies based on immune checkpoint blockade are highly effective in a subset of patients. An ongoing challenge is the identification of biomarkers that predict which patients will benefit from these therapies. Aneuploidy, also known as somatic copy number alterations (SCNAs), is widespread in cancer and is posited to drive tumorigenesis. Analyzing 12 human cancer types, we find that, for most, highly aneuploid tumors show reduced expression of markers of cytotoxic infiltrating immune cells, especially CD8+ T cells, and increased expression of cell proliferation markers. Different types of SCNAs predict the proliferation and immune signatures, implying distinct underlying mechanisms. Using published data from two clinical trials of immune checkpoint blockade therapy for metastatic melanoma, we found that tumor aneuploidy inversely correlates with patient survival. Together with other tumor characteristics such as tumor mutational load, aneuploidy may thus help identify patients most likely to respond to immunotherapy.
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Affiliation(s)
- Teresa Davoli
- Howard Hughes Medical Institute, Department of Genetics, Harvard Medical School, Division of Genetics, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Hajime Uno
- Dana-Farber Cancer Institute, Boston, MA 02215-5450, USA
| | - Eric C Wooten
- Howard Hughes Medical Institute, Department of Genetics, Harvard Medical School, Division of Genetics, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Stephen J Elledge
- Howard Hughes Medical Institute, Department of Genetics, Harvard Medical School, Division of Genetics, Brigham and Women's Hospital, Boston, MA 02115, USA.
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Gottwald L, Danilewicz M, Fendler W, Suzin J, Spych M, Piekarski J, Tylinski W, Chalubinska J, Topczewska-Tylinska K, Cialkowska-Rysz A. The AgNORs count in predicting long-term survival in serous ovarian cancer. Arch Med Sci 2014; 10:84-90. [PMID: 24701219 PMCID: PMC3953966 DOI: 10.5114/aoms.2013.36753] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Revised: 05/19/2011] [Accepted: 06/09/2011] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The value of argyrophilic nucleolar organizer regions (AgNORs) to predict survival in patients with ovarian cancer has not been clearly explained yet. The aim of study was to assess the value of analysis of the mean number of AgNORs per nucleus (mAgNOR) and mean percentage of nuclei with five or more AgNORs per nucleus (pAgNOR) in the prediction of disease-free survival (DFS) and overall survival (OS) in patients with serous ovarian cancer. MATERIAL AND METHODS The study examined 52 patients treated for serous ovarian cancer with a follow-up period of 2-143 months. After silver staining paraffin specimens from primary surgery, mAgNOR and pAgNOR in cancer cells were counted and analyzed. Age, grading, radicality of surgery and FIGO staging were analyzed as covariates. RESULTS Mean mAgNOR equaled 4.4 ±0.9 and pAgNOR equaled 42.2 ±20.8%. Both mAgNOR and pAgNOR were the lowest in G1 tumors. The mAgNOR and pAgNOR were lower in stage I than stage IV cancers. The DFS and OS rates were respectively 15.4% and 21.2%. In univariate analysis FIGO staging, grading, and pAgNOR were associated with worse prognosis, while radicality of surgery remained a significant protective factor in terms of DFS. Higher FIGO staging and older age worsened OS. In multivariate analysis FIGO staging remained significantly associated with both DFS (HR 1.98; 95% CI 1.05-3.71) and OS (HR 1.76; 95% CI 1.00-3.10), while age affected OS rates (HR 1.78; 95% CI 1.04-2.95). CONCLUSIONS mAgNOR and pAgNOR are useful markers of cellular kinetics. Prospective studies in larger populations are needed to confirm these results in terms of AgNORs' effects on survival.
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Affiliation(s)
- Leszek Gottwald
- Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland
| | - Marian Danilewicz
- Department of Nephropathology, Division of Morphometry, Medical University of Lodz, Poland
| | - Wojciech Fendler
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Poland
| | - Jacek Suzin
- Department of Gynecology and Gynecologic Oncology, I Chair of Obstetrics and Gynecology, Medical University of Lodz, Poland
| | - Michal Spych
- Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland
| | - Janusz Piekarski
- Department of Surgical Oncology, Chair of Oncology, Medical University of Lodz, Poland
| | - Wieslaw Tylinski
- Department of Gynecology and Gynecologic Oncology, I Chair of Obstetrics and Gynecology, Medical University of Lodz, Poland
| | - Justyna Chalubinska
- Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland
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Dai H, Hickey RJ, Liu J, Bigsby RM, Lanner C, Malkas LH. Error-promoting DNA synthesis in ovarian cancer cells. Gynecol Oncol 2013; 131:198-206. [PMID: 23851291 PMCID: PMC3796037 DOI: 10.1016/j.ygyno.2013.06.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 06/13/2013] [Accepted: 06/14/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The objective of this study is to determine whether an altered DNA replication process is responsible for some of genetic damage observed in ovarian cancer. METHODS The replication fidelity of the DNA synthetic process was evaluated in both malignant and non-malignant human ovarian cells. The types of replication errors produced were identified. In addition, kinetic analyses of the efficiency of ovarian cancer DNA polymerases for misincorporating nucleotides were performed. RESULTS We report for the first time that ovarian cancer cells harbor an error promoting DNA replication apparatus which contributes to the decrease in DNA synthetic fidelity exhibited by these cells. Our study also shows that the decrease in DNA replication fidelity was not a result of an increased DNA replication activity. In addition, it was observed that the higher rate of DNA replication errors does not result in significant differences in the type of DNA replication-errors made during the DNA replication process; just the relative abundance. A detailed kinetic analysis of the efficiency of misincorporating nucleotides demonstrated that the DNA polymerases within the ovarian cancer cells exhibited a significant propensity for creating purine-pyrimidine nucleotide mismatches relative to non-malignant ovarian cells, while being only slightly more efficient at incorrectly pairing a purine nucleotide with a purine nucleotide. CONCLUSIONS All together, these data suggest that the systematic analysis of the DNA replication process in ovarian cancer could uncover information on some of the molecular mechanisms that drive the accumulation of genetic damage, and probably contribute to the pathogenesis of the disease.
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Affiliation(s)
- Heqiao Dai
- Indiana University School of Medicine
- Department of Medicine
- Division of Clinical Pharmacology
| | - Robert J. Hickey
- City of Hope Beckman Research Institute
- Department of Radiation Biology
| | - Jianying Liu
- Indiana University School of Medicine
- Department of Medicine
| | - Robert M. Bigsby
- Indiana University School of Medicine
- Department of Obstetrics and Gynecology
| | - Carita Lanner
- Indiana University School of Medicine
- Department of Medicine
| | - Linda H. Malkas
- City of Hope Beckman Research Institute
- Department of Molecular and Cellular Biology
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Gottwald L, Danilewicz M, Suzin J, Wagrowska-Danilewicz M, Spych M, Tylinski W, Topczewska-Tylinska K, Piekarski J, Kazmierczak-Lukaszewicz S, Cialkowska-Rysz A. Assessment of the argyrophilic nucleolar organizer region area/nucleus ratio in ovarian serous epithelial adenomas, borderline tumors and cancers. Arch Med Sci 2013; 9:79-85. [PMID: 23515230 PMCID: PMC3598139 DOI: 10.5114/aoms.2013.33066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2010] [Revised: 09/06/2010] [Accepted: 09/26/2010] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION There is a need to assess the value of the novel potentially useful biomarkers in ovarian tumors. The aim of study was to assess the value of sAgNOR analysis in ovarian serous epithelial tumors. MATERIAL AND METHODS The analysis was performed in ovaries from 113 patients treated operatively due to serous ovarian tumors (30 adenomas, 14 borderline tumors and 69 cancers). After silver staining of paraffin specimens from surgery, sAgNOR in tumor cells was analyzed. Additionally, the value of the argyrophilic nucleolar organizer region area/nucleus ratio (sAgNOR) in the prediction of disease-free survival (DFS) and overall survival (OS) in 52 patients with serous ovarian cancer with complete follow-ups in November 2009 was evaluated. Age, grading, radicality of surgery and FIGO staging were analyzed as additional factors. RESULTS SAGNOR IN ADENOMAS, BORDERLINE TUMORS AND CANCERS WAS IN THE FOLLOWING RANGES: (0.73 ±0.23) × 10(6), (0.81 ±0.18) × 10(6) and (0.96 ±0.33) × 10(6) [AgNOR/cm(2)] respectively. In cancers from G1 to G3 sAgNOR was (1.02 ±0.32) × 10(6) (G1), (0.98 ±0.37) × 10(6) (G2) and (0.82 ±0.24) × 10(6) (G3) [AgNOR/cm(2)] respectively. In univariate analysis, but not in multivariate analysis, staging negatively correlated with better DFS and OS. sAgNOR, age of patients, grading and radicality of surgery were not associated with DFS or OS in either univariate or multivariate analysis. CONCLUSIONS sAgNOR analysis is not sufficient to precisely characterize cellular kinetics in serous ovarian tumors, and the analysis of sAgNOR, mAgNOR and pAgNOR should be performed commonly. The prognostic significance of sAgNOR in patients with serous ovarian cancer was not proven.
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Affiliation(s)
- Leszek Gottwald
- Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland
- Department of Radiotherapy, Regional Cancer Center, Copernicus Memorial Hospital of Lodz, Poland
| | - Marian Danilewicz
- Department of Nephropathology, Division of Morphometry, Medical University of Lodz, Poland
| | - Jacek Suzin
- Department of Gynecology and Gynecologic Oncology, First Chair of Obstetrics and Gynecology, Medical University of Lodz, Poland
| | | | - Michal Spych
- Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland
- Department of Radiotherapy and General Oncology, Regional Cancer Center, Copernicus Memorial Hospital of Lodz, Poland
| | - Wieslaw Tylinski
- Department of Gynecology and Gynecologic Oncology, First Chair of Obstetrics and Gynecology, Medical University of Lodz, Poland
| | | | - Janusz Piekarski
- Department of Surgical Oncology, Chair of Oncology, Medical University of Lodz, Poland
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Multidrug resistance gene (MDR-1) and risk of brain metastasis in epithelial ovarian, fallopian tube, and peritoneal cancer. Am J Clin Oncol 2011; 34:488-93. [PMID: 20921883 DOI: 10.1097/coc.0b013e3181ec5f4b] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND To evaluate risk factors that predict brain metastasis in epithelial ovarian, fallopian tube, and peritoneal cancer. METHODS All patients with FIGO stage I to IV who underwent initial cytoreductive surgery between January 1995 and January 2009 were evaluated. The tumor samples were evaluated for 7 markers including multidrug resistance gene (MDR-1), DNA aneuploidity and S-phase fraction, human epidermal growth factor receptor 2, estrogen receptor, progesterone receptor, p53 mutation, epidermal growth factor receptor, and CD31. Biomarker expression was evaluated as a predictor of hematogenous metastasis to the following locations: (i) liver and spleen, (ii) lung, and (iii) brain. RESULTS There were 309 cases identified during the period. Of those, 5 (1.6%, 95% CI: 0.2%-3.0%) women developed brain metastasis. Time to onset of brain metastasis was significantly longer than that for other recurrent sites (median time to recurrence after initial cytoreduction, brain vs. lung vs. liver, 21.4 vs. 12.6 vs. 11.0 months, P< 0.05). Significantly increased expression of MDR-1 was seen in tumors from women who developed brain metastasis (brain vs. nonbrain sites, 80% vs. 4.2%-24.3%, P= 0.004). In multivariate analysis, MDR-1 was the only significant variable associated with the risk of brain metastasis. MDR-1 expression predicted brain metastasis (receiver-operator-characteristic curve analysis, AUC 0.808, P= 0.018), and with a 10% positive expression of MDR-1 as the cutoff value, sensitivity, specificity, positive predictive value, negative predictive value, accuracy of prediction of brain metastasis were 80%, 86.1%, 15.4%, 99.3%, and 85.9%, respectively (odds ratio: 24.7, 95% CI: 2.64-232, P= 0.002). CONCLUSIONS Increased expression of MDR-1 in the tumor tissue obtained at initial cytoreduction is associated with increased risk of developing brain metastases in women with epithelial ovarian, fallopian tube, or peritoneal cancer.
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11
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Davoli T, de Lange T. The causes and consequences of polyploidy in normal development and cancer. Annu Rev Cell Dev Biol 2011; 27:585-610. [PMID: 21801013 DOI: 10.1146/annurev-cellbio-092910-154234] [Citation(s) in RCA: 312] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although nearly all mammalian species are diploid, whole-genome duplications occur in select mammalian tissues as part of normal development. Such programmed polyploidization involves changes in the regulatory pathways that normally maintain the diploid state of the mammalian genome. Unscheduled whole-genome duplications, which lead primarily to tetraploid cells, also take place in a substantial fraction of human tumors and have been proposed to constitute an important step in the development of cancer aneuploidy. The origins of these polyploidization events and their consequences for tumor progression are explored in this review.
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Affiliation(s)
- Teresa Davoli
- Laboratory for Cell Biology and Genetics, The Rockefeller University, New York, NY 10065, USA
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12
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Pires MA, Seixas F, Palmeira C, Payan-Carreira R. Histopathologic and Immunohistochemical Exam in One Case of Canine Endometrial Adenocarcinoma. Reprod Domest Anim 2009; 45:545-9. [DOI: 10.1111/j.1439-0531.2008.01243.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Kleinberg L, Pradhan M, Tropé CG, Nesland JM, Davidson B, Risberg B. Ovarian carcinoma cells in effusions show increased S-phase fraction compared to corresponding primary tumors. Diagn Cytopathol 2008; 36:637-44. [PMID: 18677760 DOI: 10.1002/dc.20879] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The objective of this study was to analyze large-scale genomic patterns during disease progression from primary tumor to effusion in ovarian carcinoma, and to study the association between DNA ploidy parameters in effusions, proliferation/survival markers, and clinicopathologic characteristics. DNA ploidy status, DNA index (DI), and S-phase fraction (SPF) were compared in 22 matched primary carcinomas (all prechemotherapy specimens) and effusions (14 prechemotherapy and 8 postchemotherapy specimens) using image analysis. The association between these parameters and previously studied cell survival/proliferation biomarkers, previous administration of chemotherapy, chemotherapy response and survival was analyzed in a larger series of 54 effusions. The majority of specimens were aneuploid irrespective of anatomic site, with no significant differences in DI. SPF was significantly higher in effusions compared to matched primary tumors (P = 0.007 for all 22 pairs, P = 0.011 for 14 matched prechemotherapy specimens). Higher SPF was related to higher Ki-67 score (P = 0.045), and both SPF and DI were directly associated with higher level of Survivin (P < 0.001 for both). DI and SPF in effusions showed no association with histological grade, FIGO stage, residual disease volume, previous chemotherapy, response to chemotherapy at primary disease, recurrence or survival. Ovarian carcinoma cells in effusions have increased proliferation compared to corresponding primary tumors, as evidence of disease progression. DNA ploidy parameters in cancer cells in effusions are unaltered by chemotherapy and appear to be unrelated to chemotherapy response and to survival, suggesting that large-scale genomic patterns at this anatomic site are not useful in segregating patients into prognostic groups.
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Affiliation(s)
- Lilach Kleinberg
- Division of Pathology, The Norwegian Radium Hospital, Rikshospitalet Medical Center, Oslo, Norway
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Janisson-Dargaud D, Durlach A, Lorenzato M, Grange F, Bernard P, Birembaut P. Aneuploidy, but not Ki-67 or EGFR expression, is associated with recurrences in basal cell carcinoma. J Cutan Pathol 2008; 35:916-21. [PMID: 18537864 DOI: 10.1111/j.1600-0560.2007.00935.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC), the most common skin cancer, has an overall excellent prognosis, but recurrences are frequent. The value of classical clinical and histological prognostic factors to predict recurrences remain limited. METHODS In order to evaluate the prognostic value of Epidermal Growth Factor Receptor (EGFR) expression, Ki-67 antigen expression and DNA ploidy, we compared primary tumors in 20 patients who had subsequent local recurrences and 20 matched controls without recurrences. DNA ploidy was determined by image cytometry, and EGFR and Ki-67 expression were studied by immunohistochemistry. RESULTS Statistical analysis of the intensity and the percentage of EGFR expression and Ki-67 antigen expression did not show any significant difference between the two groups. In contrast, we found that 78% of primary BCC in patients who experienced recurrences vs. 32% in the control group were aneuploid (p = 0.005). CONCLUSIONS Aneuploidy is a risk factor for recurrences. This factor should be useful in clinical practice and require evaluation in further studies.
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Yoon BS, Kim YT, Kim S, Lee CS, Kim JW, Kim JH, Kim SW, Cho NH. Prognostic value of nuclear DNA quantification and cyclin A expression in epithelial ovarian carcinoma. Eur J Obstet Gynecol Reprod Biol 2006; 136:110-5. [PMID: 17157431 DOI: 10.1016/j.ejogrb.2006.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2005] [Revised: 10/04/2006] [Accepted: 10/15/2006] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the correlation of DNA ploidy, S-phase fraction (SPF) and the expression of cyclin A to the clinical prognostic factors in patients with epithelial ovarian cancer. STUDY DESIGN A prospective analysis was performed on 46 ovarian tumor patients. The DNA ploidy and SPF were determined by flow cytometry and the expression of cyclin A was measured by immunohistochemical staining. RESULTS Compared with benign and borderline tumors, the malignant tumors expressed higher levels of cyclin A (P=0.007), more aneuploid cells (P=0.018) and higher SPF (P=0.015). With regard to DNA ploidy and the clinical prognostic factors, aneuploid cells increased with tumor grade (P=0.011), the disease stage (P=0.009) and residual volume (P=0.001). When residual tumor was more than 2 cm, the expression of cyclin A was increased (P=0.043). Three-year survival was low for patients with tumors expressing cyclin A in over 10% of cells (P=0.003). CONCLUSIONS The data suggest that the assessment of the DNA ploidy, SPF and the expression of cyclin A may provide important information for predicting the prognosis of epithelial ovarian cancer.
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Affiliation(s)
- Bo Sung Yoon
- Department of Obstetrics and Gynecology, Women's Cancer Clinic, Yonsei University College of Medicine, Seoul, Republic of Korea
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16
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Kaern J, Aghmesheh M, Nesland JM, Danielsen HE, Sandstad B, Friedlander M, Tropé C. Prognostic factors in ovarian carcinoma stage III patients. Can biomarkers improve the prediction of short- and long-term survivors? Int J Gynecol Cancer 2006; 15:1014-22. [PMID: 16343177 DOI: 10.1111/j.1525-1438.2005.00185.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim of the study was to determine if biomarker expression could help discriminate between short-term and long-term survivors in women with advanced ovarian cancer. Fifty-one patients with stage III ovarian cancer were selected for the study, which included 28 short-term survivors (death from ovarian cancer within 18 months) and 23 long-term survivors (alive for more than 5 years). There was no difference between the two groups with respect to FIGO substage, age, World Health Organization score, and first-line platinum therapy. Classic clinical pathologic parameters were examined together with p53, Bcl-2, Ki-67, PDGFRalpha, P-glycoprotein, BRCA1, and DNA ploidy. Immunohistochemistry was used for scoring biomarker expression and image cytometry for DNA ploidy. All patients had primary debulking surgery followed by first-line platinum therapy. On multivariate analysis, the presence of ascites, debulking surgery and repeat laparotomy, clear-cell histology, elevated CA125, and high Ki-67 score were all found to be of prognostic importance. The long-term survivors were characterized by primary optimal cytoreduction surgery (<1 cm residual disease), attempt at maximal tumor debulking by experienced gynecological oncologic surgeons, and the absence of ascites. Normal CA125 level before platinum therapy and negative Ki-67 expression also predicted a more favorable prognosis.
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Affiliation(s)
- J Kaern
- Department of Gynecologic Oncology, University of Oslo, The Norwegian Radium Hospital, Oslo, Norway.
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17
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Olaharski AJ, Sotelo R, Solorza-Luna G, Gonsebatt ME, Guzman P, Mohar A, Eastmond DA. Tetraploidy and chromosomal instability are early events during cervical carcinogenesis. Carcinogenesis 2005; 27:337-43. [PMID: 16123119 DOI: 10.1093/carcin/bgi218] [Citation(s) in RCA: 172] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Chromosomal instability as manifested by increases in aneuploidy and structural chromosome aberrations is believed to play a critical role in the intermediate to late stages in the development of cervical malignancies. The current study was designed to determine the role of tetraploidy in the formation of aneuploidy and ascertain the occurrence of these alterations during the earlier stages of cervical carcinogenesis. Cervical cell samples, with diagnoses ranging from Normal to high-grade lesions, (HSIL) were obtained from 143 women and were evaluated for chromosomal alterations using dual-probe fluorescence in situ hybridization. Cervical cells from a subset of the group were also evaluated for chromosomal instability in the form of micronuclei. The frequencies of cells exhibiting either tetrasomy or aneusomy for Chromosomes 3 and 17 increased significantly with disease progression and displayed distinctive patterns where aneusomy was rarely present in the absence of tetrasomy. The frequencies of micronuclei that formed through either chromosomal loss or breakage increased significantly in both the low-grade and high-grade diagnostic categories and were highly correlated with both the number of tetrasomic and aneusomic cervical cells. In addition, a unique chromosomal alteration involving a significant non-random loss of Chromosome 17 specific to near-tetraploid aneusomic cells (trisomy 17 and tetrasomy 3) was observed. We conclude that tetraploidy and chromosomal instability are related events occurring during the early stages of cervical carcinogenesis that predispose cervical cells to the formation of aneuploidy frequently involving the loss of Chromosome 17.
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Affiliation(s)
- Andrew J Olaharski
- Environmental Toxicology Graduate Program, Department of Cell Biology and Neuroscience, 5429 Boyce Hall, University of California, Riverside, CA-92521, USA
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18
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Büyükçelik A, Onur H, Akbulut H, Bülent Y, Ensari A, Utkan G, Onal BS, Içli F. Expression of P53 Protein and Dna Flow Cytometry in Gastric Adenocarcinoma: Implications in Patients Treated with Adjuvant Etoposide, Adriamycin and Cisplatin. TUMORI JOURNAL 2005; 91:302-8. [PMID: 16277093 DOI: 10.1177/030089160509100403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background We evaluated the prognostic value of p53 protein, DNA content and S-phase fraction in patients with adenocarcinoma of the stomach or the gastroesophageal junction treated with adjuvant etoposide, doxorubicin and cisplatin. Methods and study design Thirty-five consecutive patients with stage II or III gastric or gastroesophagial junction adenocarcinoma treated with at least two cycles of adjuvant etoposide, doxorubicin and cisplatin after curative gastric resection were included. The expression of p53 protein was determined by immunohistochemistry and DNA content by flow cytometry. The presence of p53 expression and DNA content was compared with clinicopathological features. Results Median age was 54 years (range, 31–71). P53 expression was detected in 42.9% (15 of 35) of gastric cancer tissues of the patients. Aneuploidy was observed in 31.4% of patients, and S-phase fraction was more than 10% in 22.9%. P53 immunoreactivity (33.3% vs 47.8%) was more common in advanced disease. There was no association among p53 immunoreactivity, DNA content and S-phase fraction. We also found no significant relationship between p53 immunoreactivity, DNA content, S-phase fraction or other clinicopathological parameters. In univariate analysis, the involvement of lymph nodes was a significant predictor of a poor outcome (P = 0.001). Also, p53-positive patients had a poor survival close to the level of significance (P = 0.051). Likewise, p53 immunoreactivity (P = 0.0071), in addition to lymph node involvement (P = 0.0016), were the independent prognostic factors in multivariate analysis. Conclusions This trial supports the results of previous reports that p53 immunoreactivity is a prognostic factor for patients with adenocarcinoma of stomach or gastroesophageal junction treated with adjuvant chemotherapy.
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Affiliation(s)
- Abdullah Büyükçelik
- Department of Medical Oncology, Ankara University School of Medicine, Ibni Sina Hospital, Turkey.
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Affiliation(s)
- H Fox
- University of Manchester, Manchester, UK
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20
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Kim YT, Zhao M, Kim SH, Lee CS, Kim JH, Kim JW. Prognostic significance of DNA quantification by flow cytometry in ovarian tumors. Int J Gynaecol Obstet 2005; 88:286-91. [PMID: 15733883 DOI: 10.1016/j.ijgo.2004.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2004] [Revised: 11/12/2004] [Accepted: 11/23/2004] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective of our study is to evaluate prognostic significance of DNA quantification by flow cytometry in ovarian tumor. METHODS A prospective analysis was performed on 56 ovarian tumor patients treated in the Yonsei Medical Center from Feb. 2000 to Jan. 2003. RESULTS Regarding the association between tumor grade and the DNA quantitative analysis, as tumor grade increased, the quantity of aneuploid cells and S-phase fraction (SPF) increased. In addition, SPF was increased significantly in the advanced staged patients (P=0.04) and SPF was significantly increased in aneuploid tumors (P=0.03). The overall survival rate was poor for patients with aneuploid tumors and for patients with tumors showing over SPF (10%). CONCLUSION Our data demonstrated that the prognosis was poor for patients with aneuploid cancers or increased SPF. Therefore, DNA quantification by flow cytometry may provide important information for predicting the prognosis of the disease.
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Affiliation(s)
- Y T Kim
- Department of Obstetrics and Gynecology, Institute of Women's Life Science, Yonsei University College of Medicine, Seoul, Korea
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21
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Olaharski AJ, Eastmond DA. Elevated levels of tetraploid cervical cells in human papillomavirus-positive Papanicolaou smears diagnosed as atypical squamous cells of undetermined significance. Cancer 2004; 102:192-9. [PMID: 15211479 DOI: 10.1002/cncr.20259] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Recommendations for the proper treatment of women diagnosed with an equivocal atypical squamous cells of undetermined significance (ASCUS) Papanicolaou (Pap) smear are controversial. To the authors' knowledge, there currently are no methods available that can identify accurately ASCUS/human papillomavirus (HPV)-positive women who have an increased risk of developing progressive cervical lesions without the use of invasive procedures. An additional diagnostic tool is needed to triage women properly who are diagnosed with ASCUS. Numerical chromosomal abnormalities, such as tetraploidy and aneuploidy, frequently accompany cervical carcinoma development and are believed to represent early and important genetic alterations during cervical carcinogenesis. The identification of elevated levels of numerical chromosomal aberrations in women diagnosed with ASCUS Pap smears, therefore, may be of prognostic value. METHODS Multiple-probe fluorescence in situ hybridization was used to analyze 1000 cervical epithelial cells from each of 257 women for the presence of numerical chromosomal aberrations. RESULTS A statistically significant proportion of women diagnosed with HPV-positive ASCUS had elevated levels of tetraploid cervical cells (5 of 69 women) compared with normal/HPV-negative women (0 of 75 women) (P = 0.02). CONCLUSIONS The frequency of numerical chromosomal aberrations in cervical cells obtained from the majority of women diagnosed with an ASCUS Pap smear did not differ significantly from the frequency in women with smears that were diagnosed as normal. However, a modest but statistically significant proportion of women diagnosed as HPV-positive ASCUS did have elevated levels of tetraploid cervical cells, a genetic abnormality often associated with cervical carcinogenesis, suggesting that these women may be at an increased risk of developing more advanced cervical lesions. Given these results, the authors recommend performing additional studies with histologic follow-up.
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MESH Headings
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/virology
- Chromosome Aberrations
- Chromosomes, Human, Pair 17/genetics
- Chromosomes, Human, Pair 3/genetics
- DNA Probes, HPV
- DNA, Viral/genetics
- Epithelial Cells/pathology
- Female
- Humans
- In Situ Hybridization, Fluorescence
- Papanicolaou Test
- Papillomaviridae/isolation & purification
- Papillomavirus Infections/genetics
- Papillomavirus Infections/pathology
- Papillomavirus Infections/virology
- Ploidies
- Prognosis
- Sensitivity and Specificity
- Uterine Cervical Neoplasms/genetics
- Uterine Cervical Neoplasms/pathology
- Uterine Cervical Neoplasms/virology
- Vaginal Smears
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Affiliation(s)
- Andrew J Olaharski
- Environmental Toxicology Graduate Program, Department of Cell Biology and Neuroscience, University of California, Riverside, California, USA
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Salihoglu Y, Bilir A, Aydiner A, Erkan M, Tuzlali S, Eralp Y. Thymidine labeling index in epithelial ovarian cancer. Int J Gynaecol Obstet 2001; 75:171-6. [PMID: 11684112 DOI: 10.1016/s0020-7292(01)00455-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study is to determine the thymidine labeling index and its prognostic role in patients with ovarian cancer. METHODS Tumor cell proliferation in 32 patients with primary ovarian cancer admitted to Istanbul Medical Faculty, Department of Obstetrics and Gynecology, between 1993 and 1997 was investigated using the [3H]thymidine labeling index (TLI). TLI results were compared with other clinical and histopathologic prognostic parameters. RESULTS The mean and median TLI values of the patients were 9.3+/-6.2% and 9.20% (range: 0.4-23.0%), respectively. Sixteen patients showed high proliferation rates (mean TLI: 14.3%). These patients had an overall survival rate of 46.7% at 3 years. The mean TLI level and overall survival at 3 years in the low proliferation rate group were 4.4 and 68.8%, respectively. Patients with a high TLI had a significantly shorter survival compared to those with a low TLI (P<0.01). There was tendency towards a higher TLI with advanced stage (P>0.05). However, there was no statistically significant correlation between TLI and other prognostic parameters. CONCLUSION TLI may have a predictive value in determining the outcome of patients with ovarian cancer. Further larger scale studies are needed before definite conclusions can be made about its role as a prognostic factor in this disease.
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Affiliation(s)
- Y Salihoglu
- Department of Obstetrics and Gynecology, Istanbul Faculty of Medicine, Istanbul, Turkey
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Elhafey AS, Papadimitriou JC, El-Hakim MS, El-Said AI, Ghannam BB, Silverberg SG. Computerized image analysis of p53 and proliferating cell nuclear antigen expression in benign, hyperplastic, and malignant endometrium. Arch Pathol Lab Med 2001; 125:872-9. [PMID: 11419970 DOI: 10.5858/2001-125-0872-ciaopa] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT The endometrium is an intrinsically dynamic tissue with great capability for regeneration and proliferation; consequently, there is some overlap between features seen in benign, premalignant, and malignant lesions. This leads to marked intrabiopsy, interbiopsy, and interobserver variability. OBJECTIVE We studied the specificity and sensitivity of computerized image analysis of molecular markers to evaluate its potential use as a diagnostic tool. DESIGN Specimens from 100 patients were examined and the following histologic diagnoses were assigned: proliferative endometrium (n = 10), secretory endometrium (n = 10), endometrial hyperplasia (n = 40; 30 with no atypia, 10 with atypia), and carcinoma (n = 40; 20 endometrioid, 10 serous, and 10 clear cell). All cases were evaluated immunohistochemically for p53 and proliferating cell nuclear antigen (PCNA) expression. Computerized image analysis was performed with a CAS 200 digital analyzer. RESULTS Expression of p53 was found only in carcinomas (65%) and endometrial hyperplasia with atypia (30%). Expression of p53 was higher in the poor prognostic categories (serous carcinoma and clear cell carcinoma) than in endometrioid carcinoma. In endometrioid carcinoma, p53 expression correlated with grade. Proliferating cell nuclear antigen showed a similar pattern of results to p53 in the various carcinoma subtypes and endometrioid carcinoma grades. Endometrial hyperplasia PCNA values were the lowest among all the groups. Both carcinomas and proliferative endometrium showed higher glandular and stromal PCNA values, significantly different from endometrial hyperplasia with atypia. In proliferative endometrium, stromal PCNA was the highest among all of the groups. The p53 and PCNA results correlated with each other for carcinoma. CONCLUSIONS Computerized image analysis correlates well with the established morphologic groups of endometrial pathology and yields results consistent with previous studies. Owing to its higher degree of sensitivity, computerized image analysis is of potential use in cases of diagnostic dilemmas and can help objectively allocate the case in the correct category (e.g., proliferative endometrium vs. endometrial hyperplasia, endometrial hyperplasia with atypia vs. endometrioid carcinoma). It is particularly useful in the evaluation of stromal changes.
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Affiliation(s)
- A S Elhafey
- Department of Pathology, University of Maryland Medical System, Baltimore, MD 21201, USA
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Meyer JS, Gersell DJ, Yim S. Cell Proliferation in Ovarian Carcinoma: Superior Accuracy of S-Phase Fraction (SPF) by DNA Labeling Index versus Flow Cytometric SPF, Lack of Independent Prognostic Power for SPF and DNA Ploidy, and Limited Effect of SPF on Tumor Growth Rate. Gynecol Oncol 2001; 81:466-76. [PMID: 11371140 DOI: 10.1006/gyno.2001.6184] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The goal of this work was to test the hypotheses that S-phase fraction (SPF) by DNA labeling index (SPF-LI) would predict the course of the disease for ovarian/peritoneal carcinomas and that SPF-LI would correlate better with pathologic classification and outcome than SPF by DNA flow cytometry (SPF-F). METHODS Tritiated thymidine (1985-1988) and bromodeoxyuridine (1988-1999) DNA labeling (SPF-LI) was evaluated in vitro on 178 tumors. Cellular DNA and SPF-F were measured flow cytometrically. During this time, 90% of ovarian/peritoneal tumors accessioned in surgical pathology were studied. RESULTS Tumors of low malignant potential (LMP, "borderline") had low SPF-LI (median = 1.2%). High-grade invasive carcinomas of various types and carcinosarcomas all had high SPF-LI (medians = 11.2-23.4%). Serous low-grade invasive carcinomas (median = 1.05) resembled LMP tumors. SPF-LI of ovarian carcinomas other than LMP tumors increased slightly as FIGO stage increased (P = 0.07). Survival of patients with high-grade ovarian carcinomas was not predicted by SPF-LI or SPF-F, nor was DNA ploidy predictive. SPF-LI produced tighter distributions for various tumor types than did SPF-F. Neither SPF nor DNA ploidy contributed to prediction of outcome when tumor type and stage were included in multivariate models. We calculated the mean cell loss rate of high-grade carcinomas to be 94%. CONCLUSIONS LMP ovarian/peritoneal tumors have low proliferation rates in contrast to high-grade carcinomas. Proliferation correlated with tumor type and stage, but neither it nor DNA ploidy predicted survival independently. Proliferation rate is growth limiting only when low. At higher levels cell loss limits growth. SPF-LI measures proliferation more accurately than SPF-F; SPF-F is not sufficiently reliable for clinical use.
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Affiliation(s)
- J S Meyer
- Department of Pathology, St. Luke's Hospital, 232 South Woods Mill Road, Chesterfield, Missouri 63017, USA
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Roels SL, Van Daele AJ, Van Marck EA, Ducatelle RV. DNA ploidy and nuclear morphometric variables for the evaluation of melanocytic tumors in dogs and cats. Am J Vet Res 2000; 61:1074-9. [PMID: 10976739 DOI: 10.2460/ajvr.2000.61.1074] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the prognostic importance of the DNA content and nuclear morphometric variables in melanocytic tumors of cats and dogs. SAMPLE POPULATION 27 melanocytic tumors of dogs and cats. PROCEDURES Biopsy specimens were investigated by quantitative image analysis after the Feulgen staining method. The DNA content (index), nuclear diameter, ploidy balance, proliferation index, hyperploidy, and growth fraction (Ki67) were measured. Using 1-way ANOVA and a Pearson correlation test, the relationships between the different variables were tested. Their role in the prognosis in affected dogs and cats was estimated using the Cox regression test with respect to 6 months postoperative survival rate. RESULTS Significant correlations were found between DNA index and ploidy balance and proliferation index. A significant correlation was also found between hyperploidy and DNA index, and between ploidy balance and proliferation index. Significant differences were found between histologically malignant and benign melanocytic tumors but not between primary malignant tumors and metastatic malignant tumors for DNA index and ploidy balance. No correlation was found between DNA variables and survival time. CONCLUSION AND CLINICAL RELEVANCE In melanocytic tumors of cats and dogs, DNA index and ploidy balance can be used to differentiate histologically benign from malignant tumors. However, DNA content and nuclear morphometric variables have little value in predicting survival time. The DNA index and ploidy balance provide an additional tool to evaluate melanocytic tumors of cats and dogs. Survival in dogs and cats with melanocytic tumors, however, is not determined by modifications of DNA content or changes in nuclear morphometry of tumor cells.
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Affiliation(s)
- S L Roels
- Department of Biocontrol, Veterinary and Agrochemistry Research Centre, Brussels, Belgium
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Tropé C, Kaern J, Hogberg T, Abeler V, Hagen B, Kristensen G, Onsrud M, Pettersen E, Rosenberg P, Sandvei R, Sundfor K, Vergote I. Randomized study on adjuvant chemotherapy in stage I high-risk ovarian cancer with evaluation of DNA-ploidy as prognostic instrument. Ann Oncol 2000; 11:281-8. [PMID: 10811493 DOI: 10.1023/a:1008399414923] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
PURPOSE Adjuvant chemotherapy versus observation and chemotherapy at progression was evaluated in 162 patients in a prospective randomized multicenter study. We also evaluated DNA-measurements as an additional prognostic factor. PATIENTS AND METHODS Patients received adjuvant carboplatin AUC 7 every 28 days for six courses (n = 81) or no adjuvant treatment (n = 81). Eligibility included surgically staged and treated patients with FIGO stage I disease, grade 1 aneuploid or grade 2 or 3 non-clear cell carcinomas or clear cell carcinomas. Disease-free (DFS) and disease-specific (DSS) survival were end-points. RESULTS Median follow-up time was 46 months and progression was observed in 20 patients in the treatment group and 19 in the control group. Estimated five-year DFS and DSS were 70% and 86% in the treatment group and 71% and 85% in the control group. The hazard ratio was 0.98 (95% confidence interval (95% CI): 0.52-1.83) regarding DFS and 0.94 (95% CI: 0.37-2.36) regarding DSS. No significant differences in DFS or DSS could be seen when the log-rank test was stratified for prognostic variables. Therefore, data from both groups were pooled for the analysis of prognostic factors. DNA-ploidy (P = 0.003), extracapsular growth (P = 0.005), tumor rupture (P = 0.04), and WHO histologic grade (P = 0.04) were significant independent prognostic factors for DFS with P < 0.0001 for the model in the multivariate Cox analysis. FIGO substage (P = 0.01), DNA ploidy (P < 0.05), and histologic grade (P = 0.05) were prognostic for DSS with a P-value for the model < 0.0001. CONCLUSIONS Due to the small number of patients the study was inconclusive as regards the question of adjuvant chemotherapy. The survival curves were superimposable, but with wide confidence intervals. DNA-ploidy adds objective independent prognostic information regarding both DFS and DSS in early ovarian cancer.
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Affiliation(s)
- C Tropé
- Department of Gynecologic Oncology, The Norwegian Radium Hospital, Oslo.
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Sasaki M, Ishida T, Horiuchi H, MacHinami R. Dermatofibrosarcoma protuberans: an analysis of proliferative activity, DNA flow cytometry and p53 overexpression with emphasis on its progression. Pathol Int 1999; 49:799-806. [PMID: 10504551 DOI: 10.1046/j.1440-1827.1999.00944.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of this study is to evaluate the degree and spectrum of malignancy of dermatofibrosarcoma protuberans (DFSP) in the aspect of proliferative activity, flow cytometric DNA analysis, and p53 immunoreactivity. Twenty-three tumors from 19 cases of DFSP including three cases of DFSP with fibrosarcomatous areas (DFSP-FS) were studied in comparison with its allied fibrohistiocytic tumors; that is, dermatofibroma (DF; 46 cases), fibrosarcoma (FS; four cases), and malignant fibrous histiocytoma (MFH; 11 cases). MIB-1 labeling index (LI) of DFSP was significantly higher than that of DF and was lower than those of FS and of MFH. In ordinary DFSP, the recurrent tumors exhibited significantly higher MIB-1 LI than that of the primary tumors, whereas the primary tumors showed almost the same proliferative activity of DF. DFSP-FS tended to have a higher proliferative activity than DFSP without FS-area (ordinary DFSP). In five of 19 cases of DFSP, aneuploidy (near-diploidy) was found in four recurrent and one primary tumors. Immunohistochemical p53 overexpression was found in three of 19 cases of DFSP which also showed higher proliferative activity and aneuploidy. All cases of DF were immunohistochemically negative for p53, but most of the cases of FS and MFH were positive. Although DFSP has been classified in a category of fibrohistiocytic tumor of intermediate malignancy, the recurrent DFSP, DFSP-FS, and DFSP with aneuploidy and/or p53 overexpression could be a subgroup of DFSP with more aggressive clinical behavior than ordinary primary ones.
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Affiliation(s)
- M Sasaki
- Department of Pathology, Faculty of Medicine, The University of Tokyo, Japan
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Reles AE, Gee C, Schellschmidt I, Schmider A, Unger M, Friedmann W, Lichtenegger W, Press MF. Prognostic significance of DNA content and S-phase fraction in epithelial ovarian carcinomas analyzed by image cytometry. Gynecol Oncol 1998; 71:3-13. [PMID: 9784312 DOI: 10.1006/gyno.1998.5156] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of this study was to evaluate the prognostic significance of DNA ploidy and S-phase fraction (SPF) in epithelial ovarian carcinomas analyzed by image cytometry. Frozen tissue of 103 epithelial ovarian carcinomas was analyzed for DNA ploidy and SPF with a Cell Analysis System Image Analyser (CAS 200, Becton-Dickinson) and correlations with clinical and histomorphologic factors and time to progression and overall survival were evaluated by univariate and multivariable analysis. Fifty-four percent of the ovarian carcinomas were found to be diploid, 38% aneuploid, and 8% tetraploid. The S-phase fraction was low (<5%) in 27%, intermediate (5-14.5%) in 47%, and high (>/=14.5%) in 26% of the patients. By univariate analysis overall survival and time to progression were significantly correlated with the S-phase fraction (P = 0.003 and P = 0.003), but not with DNA ploidy (P = 0. 31 and P = 0.51). A DNA index > 1.4 was correlated with poor outcome but the result did not achieve formal statistical significance (P = 0.08 and P = 0.12). A high SPF was a strong predictor of early recurrence, while a low SPF identified patients with a favorable long-term outcome. Other significant predictors of survival were FIGO stage, grade of differentiation, presence of distant metastasis, residual tumor, lymph node metastasis, and patient age. In multivariable statistical analysis only FIGO stage, histologic grade, and residual tumor after surgery were independent predictors of overall survival and time to progression.
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Affiliation(s)
- A E Reles
- Virchow-Klinikum, Humboldt University, Berlin, 13347, Germany
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30
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Shimizu Y, Kamoi S, Amada S, Hasumi K, Akiyama F, Silverberg SG. Toward the development of a universal grading system for ovarian epithelial carcinoma. I. Prognostic significance of histopathologic features--problems involved in the architectural grading system. Gynecol Oncol 1998; 70:2-12. [PMID: 9698465 DOI: 10.1006/gyno.1998.5051] [Citation(s) in RCA: 120] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Because there is no universally accepted grading system for ovarian epithelial carcinoma, we attempted to compare the prognostic utility of the individual components used in some systems--both architectural and cytologic features, as well as mitotic activity and histologic tumor type--to determine which of these components fit best with survival. METHODS We studied 461 patients with invasive ovarian carcinoma who had uniform treatment, complete clinical data including staging and follow-up, and slides available for review. Each tumor was assigned a histologic subtype, architectural grade (based on whether the predominant pattern was glandular, papillary or solid), nuclear grade, mitotic count, and FIGO grade (based on the system for endometrial carcinoma). These features were compared with each other and with tumor stage and survival. RESULTS The architectural grade, nuclear grade, and mitotic count were independent variables both in stage I/II and stage III/IV disease. Each of them correlated with survival for most combinations of histologic type and stage. By multivariate analysis, in stage I/II cancer, nuclear grade and architectural grade were significantly correlated with survival, mitotic count showed only a trend, and FIGO grade did not correlate. In stage III/IV disease, nuclear grade, architectural grade 3, and mitotic count were significant, and FIGO grade was not. CONCLUSION The new architectural grading system proposed worked better than the FIGO system in this study. Furthermore, it could be applied to all histologic subtypes of carcinoma. The nuclear grade and mitotic count were also independent of each other, correlated with survival, and could be utilized for all histologic types. These data support the development of a grading system which combines these architectural, nuclear, and mitotic features and can be applied regardless of the histologic type of carcinoma, modeled after the Nottingham system for grading of breast carcinoma.
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Affiliation(s)
- Y Shimizu
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
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31
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Affiliation(s)
- C Tropé
- Gynecologic Oncology Department, Norwegian Radium Hospital, Montebello, Oslo, Norway
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32
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Curling M, Stenning S, Hudson CN, Watson JV. Multivariate analyses of DNA index, p62c-myc, and clinicopathological status of patients with ovarian cancer. J Clin Pathol 1998; 51:455-61. [PMID: 9771445 PMCID: PMC500749 DOI: 10.1136/jcp.51.6.455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIM To determine if either DNA index or p62c-myc is an independent prognostic variable in ovarian cancer. METHODS Multivariate and univariate analyses of the relation between DNA index, p62c-myc, FIGO stage, histological type, tumour grade, completeness of surgery, and patient survival in ovarian cancer were examined. RESULTS Multivariate analysis showed significant association of survival only with stage and grade. There was no relation between survival and DNA index. CONCLUSIONS DNA index is not an independent prognostic variable in ovarian cancer.
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MESH Headings
- Analysis of Variance
- Biomarkers, Tumor/analysis
- Carcinoma, Endometrioid/genetics
- Carcinoma, Endometrioid/mortality
- Carcinoma, Endometrioid/pathology
- Cystadenoma, Mucinous/genetics
- Cystadenoma, Mucinous/mortality
- Cystadenoma, Mucinous/pathology
- Cystadenoma, Papillary/genetics
- Cystadenoma, Papillary/mortality
- Cystadenoma, Papillary/pathology
- Cystadenoma, Serous/genetics
- Cystadenoma, Serous/mortality
- Cystadenoma, Serous/pathology
- DNA, Neoplasm/analysis
- Data Collection
- Female
- Flow Cytometry
- Humans
- Multivariate Analysis
- Neoplasm Staging
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/mortality
- Ovarian Neoplasms/pathology
- Prognosis
- Proto-Oncogene Proteins c-myc/analysis
- Survival Rate
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Affiliation(s)
- M Curling
- Clinical Oncology Unit, Medical School, Cambridge, UK
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33
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King KL, Hwang JJ, Chau GY, Tsay SH, Chi CW, Lee TG, Wu LH, Wu CW, Lui WY. Ki-67 expression as a prognostic marker in patients with hepatocellular carcinoma. J Gastroenterol Hepatol 1998; 13:273-9. [PMID: 9570240 DOI: 10.1111/j.1440-1746.1998.01555.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Ki-67 expression in tumours has been shown to be associated with prognosis in patients with hepatocellular carcinoma (HCC). In this study, primary HCC samples were obtained from 67 patients undergoing surgical resection. None of these patients had been subjected previously to any other form of therapy, such as arterial embolization or chemotherapy. Histologically normal liver tissues from liver resection for metastatic colon cancer were taken as controls (n = 8). Monoclonal antibody against Ki-67 was used for immunostaining and flow cytometry was used to measure tumour DNA ploidy. The mean Ki-67 labelling index (percentage of Ki-67-positive cells) of the HCC (26 +/- 22%; range 0.1-89%) was significantly higher than that of the normal controls (39 +/- 0.8%, P < 0.05). The mean Ki-67 labelling index (19 +/- 15%; n = 28) of the tumours with diploid DNA pattern was significantly lower than those with aneuploid DNA pattern (32 +/- 25%, n = 39; P = 0.01). Hepatocellular carcinoma patients (n = 47) with Ki-67 index > 10% had a significantly lower disease-free and overall survival than those (n = 20) with Ki-67 index < or = 10% (P = 0.0009 and P = 0.02, respectively). Multivariate analysis showed that Ki-67 expression and tumour node metastasis stage were two independent prognostic factors for disease-free and overall survival rates. Our results suggest that the expression of Ki-67 is an independent prognostic indicator for patients with HCC after resection and could be of assistance in the decision-making of adjuvant therapy.
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Affiliation(s)
- K L King
- Department of Surgery, Veterans General Hospital-Taipei and National Yang-Ming University, Taiwan, Republic of China.
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34
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Darai E, Walker-Combrouze F, Dauge-Geoffroy MC, Vincent Y, Feldmann G, Madelenat P, Scoazec JY. Ki 67 expression in 35 borderline ovarian tumours: relations with clinicopathologic parameters and ploidy. Eur J Obstet Gynecol Reprod Biol 1998; 76:175-80. [PMID: 9481570 DOI: 10.1016/s0301-2115(97)00169-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To test the diagnostic and prognostic interest of Ki 67 expression and DNA ploidy in ovarian tumours. METHODS The reactivity of tumour cells with the monoclonal antibody MIB 1 against Ki 67, was assessed by an indirect immunoperoxidase staining technique applied to 25 benign, 35 borderline and 20 malignant tumours of the ovary. In each cases, ploidy was analyzed by DNA flow cytometry. RESULTS Ki 67 immunopositivity was detected in three benign tumours (12%), 14 borderline tumours (40%) and 14 ovarian carcinomas (70%). The mean and standard deviation of Ki 67 positive cells in benign, borderline and malignant tumours were: 1% +/- 8, 5% +/- 9.6 and 44.5% +/- 31 respectively. A difference in Ki 67 immunostaining was found between carcinomas and benign tumours (P < 0.0001), and between borderline and carcinomas (P = 0.001) but not between benign and borderline tumours. Evaluable DNA histograms from flow cytometry were generated in 77 cases (96.2%) of ovarian tumours. All 25 benign, 97.1% of 35 borderline and 44.5% of 20 malignant ovarian tumours were diploid. A difference was found between borderline and carcinomas (P = 0.001), but not between borderline and benign tumours. CONCLUSION Ki 67 labelling was correlated with neither histologic and prognostic parameters, nor with survival, nor with DNA ploidy in borderline ovarian tumours.
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Affiliation(s)
- E Darai
- Service de Gynécologie, Hôpital Bichat-Claude Bernard, Paris, France
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35
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Silvestrini R, Daidone MG, Veneroni S, Benini E, Scarfone G, Zanaboni F, Villa A, Presti M, Danese S, Bolis G. The clinical predictivity of biomarkers of stage III-IV epithelial ovarian cancer in a prospective randomized treatment protocol. Cancer 1998. [DOI: 10.1002/(sici)1097-0142(19980101)82:1<159::aid-cncr20>3.0.co;2-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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38
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Abstract
The high affinity folate binding protein (FBP) is overexpressed in ovarian cancers. However, its role in the pathogenesis and biological behaviour of these neoplasms is not clearly understood. Using the monoclonal antibody (MAb) MOv 18 and cytofluorimetric analysis, we investigated FBP expression in frozen neoplastic tissues from 136 patients diagnosed with epithelial ovarian cancer. FBP values were compared with clinico-pathological characteristics (age, stage, histologic grade, histologic type, DNA ploidy, percentage of S-phase cells, and previous chemotherapeutic treatment). Some amount of FBP overexpression was observed in 122 of the 136 tumours examined. The overall mean value of FBP fluorescence index (FBP FI) was 5.6 (median 2.7; min 0.8--max, 78.9). By univariate analysis, FBP FI was overexpressed to a higher degree in ovarian neoplasms with high histologic grade, advanced stage, serous histology, aneuploid status, and high percentage of cells in S-phase. Of the total number (136) of cases, 106 had all the parameters assessed and were thus selected for stepwise selection procedure. The only significant independent variable was the percentage of S-phase cells, which accounted for about 31% of variance of FBP FI. Our results indicate that FBP is associated with parameters of biological aggressiveness in ovarian cancers.
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Affiliation(s)
- G Toffoli
- Division of Experimental Oncology, Centro di Riferimento Oncologico, Aviano, Italy
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39
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Abstract
BACKGROUND AND OBJECTIVES The relationship of the tumor DNA content to survival of patients with advanced epithelial cancer has not yet been clarified. A large amount of contradictory data exists in the literature. This study analyzes the putative relationship between ploidy and advanced ovarian carcinoma. METHODS A retrospective analysis of tumor ploidy, DNA index, and the S-phase fraction from 35 patients with nonborderline epithelial ovarian carcinomas was determined by flow cytometry of paraffin-embedded tissue. All patients had FIGO stage III or IV disease. Those patients who survived > 5 years were assigned to Group A (10 patients). Group B consisted of 25 age-matched subjects who succumbed to their disease within 5 years of diagnosis. RESULTS Group A had not reached a median overall survival with a median follow-up of 114 months (range 67-226), whereas Group B had a median overall survival of 17 months (range 1-48). Two of the patients in Group A and all of the patients in group B had died of the disease. The two groups were similar in age, histologic type, and treatment. In Group A, three patients had grade 1 tumors, in contrast to group B where all the patients had either grade 2 or 3 disease (P = 0.018). However, the distribution of aneuploidy was similar in both groups. Also, the DNA indices were similar: 1.40 +/- 0.42 in Group A, and 1.36 +/- 0.44 in Group B. The median S-phase fraction was 14% (range 3-23%) in Group A, and 15% (range 2-23%) in Group B. The grade and type of tumor were not related to the ploidy or the DNA index. There was no significant correlation between ploidy or the DNA index and survival. CONCLUSION This study suggests that the DNA content of tumor as measured by flow cytometry is not a predictor of long-term survival in ovarian cancer patients with advanced disease.
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Affiliation(s)
- E Resnik
- Department of Obstetrics and Gynecology, Cancer Care Center, Lutheran General Hospital, Park Ridge, Illinois, USA
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40
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Zanetta G, Keeney GL, Cha SS, Farr GH, Katzmann JA, Wieand HS, Edmonson JH, Podratz KC. Flow-cytometric analysis of deoxyribonucleic acid content in advanced ovarian carcinoma: its importance in long-term survival. Am J Obstet Gynecol 1996; 175:1217-25. [PMID: 8942491 DOI: 10.1016/s0002-9378(96)70031-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Our purpose was to evaluate the importance of deoxyribonucleic acid content to long-term survival from advanced epithelial ovarian carcinoma. STUDY DESIGN Clinical and pathologic prognostic factors, including deoxyribonucleic acid content measured by means of flow cytometry, were analyzed for 282 patients. RESULTS In 80% of the patients, the deoxyribonucleic acid patterns were nondiploid. In univariate analysis stage (p < 0.0001), residual disease (p < 0.0001), deoxyribonucleic acid index (p = 0.01), and deoxyribonucleic acid ploidy (p = 0.02) significantly predicted progression-free survival. In multivariate analysis stage (p < 0.001), residual tumor (p = 0.001), deoxyribonucleic acid ploidy (p = 0.02), and deoxyribonucleic acid index (p = 0.02) retained independent prognostic value. Residual disease and deoxyribonucleic acid content retained independent prognostic value for stage III tumors but not for stage IV tumors. CONCLUSION Deoxyribonucleic acid analysis with flow cytometry provides prognostic information about long-term progression-free survival from advanced ovarian carcinoma and should be considered in the stratification processes of patients in future clinical trials. This prognostic information appears to be inversely related to tumor burden.
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Affiliation(s)
- G Zanetta
- Mayo Clinic, Rochester, MN 55905, USA
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41
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Zamulaeva IA, Podgorodnichenko VK, Guseva LI, Krikunova LI, Saenko AS. Prognostic significance of S-phase fraction detected by antithymidine antibodies in epidermoid cervix carcinomas. Int J Radiat Oncol Biol Phys 1996; 36:685-8. [PMID: 8948354 DOI: 10.1016/s0360-3016(96)00370-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To assess the predictive value of pretreatment proliferative activity of epidermoid cervix carcinoma cells with respect to short- and long-term results of radiotherapy. METHODS AND MATERIALS The proliferative activity of 25 epidermoid cervix carcinomas was evaluated as the immunofluorescent labeling index (LI) by rabbit antithymidine antibodies reacting specifically with single-stranded DNA of replication forks in S-phase cells. The short-term clinical outcome was estimated at 3-6 months after treatment by visual and palpatory examination. Three-year follow-up data were obtained through hospital charts and correspondence with referring physicians for only 19 patients. RESULTS There was no statistically significant association between LI and such conventional prognostic factors as clinical stage. The LI value of cervix carcinomas was significantly associated with complete regression at 3-6 months after radiotherapy and 3-year disease-free survival. Complete regression at 3-6 months was observed in 87.5% patients with fast proliferating tumors (LI > 7.0%), and only in 41.2% patients with slowly proliferating tumors (p = 0.03). Probability of 3-year disease-free survival was 85.7% in patients with fast proliferating tumors and 50.0% in those with slowly proliferating tumors (p = 0.05). CONCLUSIONS The immunofluorescent LI of epidermoid cervix carcinoma is able to provide prognostic information on short-term tumor response to radiotherapy and disease-free survival.
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Affiliation(s)
- I A Zamulaeva
- Medical Radiological Research Center, Department of Radiation Biochemistry, Obninsk, Russia
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42
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Chen TM, Chen YH, Wu CC, Chen CA, Chang CF, Hsieh CY. Factors influencing tumor cell kinetics in cervical cancer. J Cancer Res Clin Oncol 1996; 122:504-8. [PMID: 8698752 DOI: 10.1007/bf01187164] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Fresh tumor tissues instead of paraffin-embedded sections were used to study the clinical significance of the tumor cell kinetics in cervical carcinomas by flow cytometry. We analyzed specimens from 153 women with cervical cancer, and DNA aneuploidy was found in 61 cases (39.9%). The mean age of patients with aneuploid tumors was significantly higher than the age of patients with diploid tumors (P < 0.001). The mean proliferation index for aneuploid tumors was significantly higher than those for diploid tumors. There was a significant correlation between the proliferation index and age. However, tumor cell kinetics is not related to the status of human papillomavirus, herpes simplex virsuses I and II, lymph nodes, histology or tumor size. The mean age and S-phase fraction for stage-II tumors were significantly higher than those for stage-I tumors (P < 0.01). The tumors of menopausal patients exhibited a relatively higher rate of lymph node metastasis, and significantly higher aneuploidy rate and proliferation index than tumors of premenopausal patients. In summary, age and, what is more important, menopausal status may significantly influence DNA ploidy and cell kinetics of tumors, and subsequently influence clinical stage and lymph node metastasis. However, tumor cell kinetics is of limited value in the prediction of lymph node metastasis and prognosis.
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Affiliation(s)
- T M Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei
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Demirel D, Laucirica R, Fishman A, Owens RG, Grey MM, Kaplan AL, Ramzy I. Ovarian tumors of low malignant potential. Correlation of DNA index and S-phase fraction with histopathologic grade and clinical outcome. Cancer 1996; 77:1494-500. [PMID: 8608534 DOI: 10.1002/(sici)1097-0142(19960415)77:8<1494::aid-cncr11>3.0.co;2-v] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND DNA ploidy and/or S-phase fraction have been used as biologic predictors of aggressive behavior in a variety of solid tumors, including ovarian carcinomas. Recently, attention has focused on borderline lesions to determine if flow cytometry plays a role in separating potentially aggressive tumors from those which will pursue a more innocuous course. METHODS Paraffin-embedded tissue from 42 tumors with low malignant potential (LMP) were analyzed by flow cytometry (FC) to determine the DNA index (DI) and S-phase fraction (SPF). These result were then correlated with conventional pathologic parameters (size, nuclear grade, architecture, and mitotic index) and with clinical parameters (stage and age). Statistical analysis was carried out using the Fisher's Exact and Kruskal-Wallis tests. RESULTS Thirty-five cases (83.3%) were diploid, while 7 cases (16.7%) showed aneuploid stemlines, with a mean DI of 1.2 (range: 1.1-1.4). The mean SPF was 3.5% for the diploid tumors and 4.5% for the aneuploid tumors. Serous tumors comprised 74% of our cases; the remainder were either mucinous or endometrioid tumors. Complex solid architectural patterns were found in 29 tumors whereas high nuclear grade was seen in 24. A mitotic rate (MR) of 0-3/10 high power fields was seen in 29 tumors (69%), with only 5 having 10 or more mitotic figures. Aneuploidy statistically correlated with higher stage (P < 0.009). Marginal correlation was seen with a larger tumor size (P = 0.06). SPF showed a direct linear correlation with MR (P < 0.001). Also, smaller SPF's were seen in the serous tumors versus the mucinous and endometroid group (P < 0.05). Two patients with diploid and one patient with aneuploid stemlines had recurrent disease during the follow-up period. CONCLUSIONS DI and SPF correlated with some of the histologic parameters we evaluated. DI and SPF, however, could not predict which tumor(s) would behave in a more aggressive fashion.
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Affiliation(s)
- D Demirel
- Department of Pathology, Baylor College of Medicine, Houston, Texas 77030, USA
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Emura I, Naito M, Kakihara T, Wakabayashi M, Hayashi N, Chou T. Identification of drug-resistant myeloid leukemic cells by measurement of DNA content, nuclear area, and detection of P-glycoprotein. Cancer 1996. [DOI: 10.1002/(sici)1097-0142(19960301)77:5<878::aid-cncr11>3.0.co;2-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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45
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Early ovarian cancer: A review of its genetic and biologic factors, detection, and treatment. Curr Probl Cancer 1996. [DOI: 10.1016/s0147-0272(96)80005-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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46
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Ito H, Yonemura Y, Fujita H, Tsuchihara K, Kawamura T, Nojima N, Fujimura T, Nose H, Endo Y, Sasaki T. Prognostic relevance of urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitors PAI-1 and PAI-2 in gastric cancer. Virchows Arch 1996; 427:487-96. [PMID: 8624578 DOI: 10.1007/bf00199509] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Expression of urokinase-type plasminogen activator (uPA), plasminogen activator inhibitor-1 (PAI-1) and plasminogen activator inhibitor-2 (PAI-2) was evaluated in 125 surgically resected gastric cancers by immunohistochemical analysis. Tissue was stained immunohistochemically with a monoclonal antibody against human uPA and monoclonal antibodies against human PAI-1 and PAI-2. In addition, DNA ploidy patterns were determined by cytofluorometer after staining with propidium iodide. We found that 82 (66%) of the 125 gastric cancers expressed uPA as diffuse cytoplasmic staining, as intensely outlined luminal borders. PAI-1 expression was observed in 62 (50%) of 125 gastric cancer as a fine, diffuse and granular pattern in the cytoplasm. PAI-2 expression was observed in 65 (52%) of the 125 gastric cancers as a diffuse cytoplasmic staining. uPA-positive tumours showed a higher incidence of infiltration, lymph node metastasis and peritoneal dissemination that uPA-negative ones. Patients with uPA-positive tumours proved to have a significantly poorer prognosis than those with negative ones. PAI-1-negative tumours showed a higher incidence of liver metastasis and carried a poorer prognosis than PAI-1-positive ones. There was no significant correlation between uPA or PAI-1 expression and DNA ploidy patterns. Conversely, there was no significant relationship between PAI-2 expression and clinicopathological parameters and prognosis. According to the expression of uPA and PAI-1 status, groups of 19 uPA(-)/PAI-1(-), 44 uPA(+)/PAI-1(-), 23 uPA(-)/PAI-1(+) and 39 uPA(+)/PAI-1(+) were subdivided. Tumours with uPA(+)/PAI-1(-) had a significantly higher incidence of liver metastasis, lymph node metastasis and serosal invasion than the other groups of tumours. Patients with uPA(+)/PAI-1(-) tumours had a significantly poorer prognosis than those with uPA(-)/PAI-1(+) tumours. These results indicate that uPA expression is a useful biological prognostic indicator, and that uPA expression is a useful biological prognostic indicator, and that uPA and PAI-1 may play an important part in the tumour progression and metastasis in gastric cancer.
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Affiliation(s)
- H Ito
- The Second Department of Surgery, School of Medicine, Kanazawa University, Ishikawa, 920 Japan
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Nicosia SV. Ovarian and Peritoneal Borderline Neoplasms: Histopathology, Diagnostic Pitfalls, and Prognostication. Cancer Control 1996; 3:58-65. [PMID: 10825277 DOI: 10.1177/107327489600300109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- SV Nicosia
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA
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48
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Auer G, Einhorn N, Nilsson B, Silfverswärd C, Sjövall K. Biological malignancy grading in early-stage ovarian carcinoma. Acta Oncol 1996; 35 Suppl 8:93-8. [PMID: 9073054 DOI: 10.3109/02841869609098526] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The usefulness of adjuvant therapy in early ovarian cancer is a matter of controversy and there is a need for predictive methods to distinguish between low and high risk patients. Specimens from 95 early-stage ovarian cancer patients have been analysed for conventional clinical variables as well as for the biological markers--DNA content, MIB-1, p53, WAF-1--and correlated to survival. Prognostic significance achieved in univariate analysis could be improved by using a score based on several biological markers. Using a score based on DNA content, MIB-1, p53 and WAF-1, a significant predictor could be achieved with the aim of determining the postsurgical therapy. By using this tool, it is hoped that adjuvant therapy can be avoided for one-third of the patients with early-stage ovarian cancer.
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Affiliation(s)
- G Auer
- Department of Gynecology, Karolinska Hospital, Stockholm, Sweden
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49
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Frigerio L, Sassi I, Mangili F, Mariani A, Agnello A, Galli L, Mangili G, Rabaiotti E, Ferrari A. Prognostic effect of DNA content depends on the amount of the residual disease in ovarian tumours. J OBSTET GYNAECOL 1996. [DOI: 10.3109/01443619609030098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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50
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Shackney SE, Singh SG, Yakulis R, Smith CA, Pollice AA, Petruolo S, Waggoner A, Hartsock RJ. Aneuploidy in breast cancer: a fluorescence in situ hybridization study. CYTOMETRY 1995; 22:282-91. [PMID: 8749778 DOI: 10.1002/cyto.990220404] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Although ploidy is associated with the development and progression of most breast cancers, the value of flow cytometric ploidy as a clinical prognostic factor remains controversial. The technique of fluorescence in situ hybridization (FISH) can be used not only to determine overall ploidy, but also to assess the over-representation or under-representation of specific chromosomes in interphase cells. This information may be of prognostic value. We studied 84 primary breast cancers and 20 metastatic tumors by FISH, using chromosome-specific fluorescent centromeric probes. Of these, 100 cases were also studied by DNA flow cytometry. The FISH studies were concordant with DNA flow cytometry with regard to distinguishing aneuploid from diploid tumors in 78% of cases. The FISH data suggested that aneuploidy arises by a process of chromosome complement doubling with subsequent chromosome loss. In tumors that exhibited evidence of more than one round of chromosome complement doubling, the selective accumulation of multiple copies of specific chromosomes or chromosome segments was common. Multiple copies of chromosomes centromeres 1, 3, and 17 were accumulated selectively in the cells of individual tumors more frequently than chromosomes centromeres 7, 11, and 16. Multiple copies of chromosomes centromeres 10 and 20 were selectively accumulated only rarely, if at all. Aneuploidy in breast cancer can be divided into distinct stages using fluorescence in situ hybridization techniques. The stages of aneuploidy provide potential landmarks in the genetic evolution of this disease with possible links to chromosome-specific evolutionary changes.
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Affiliation(s)
- S E Shackney
- Laboratory of Cancer Cell Biology and Genetics, Allegheny-Singer Research Institute, Pittsburgh, Pennsylvania 15212-4772, USA
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