Adenocarcinoma and mixed carcinoma of the uterine cervix. II. Prognostic value of nuclear DNA analysis.

Abstract

The prognosis of the glandular neoplasms of the uterine cervix is related to the clinical stage and, to a lesser extent, to the histologic type, growth pattern, and degree of differentiation of the neoplasms. To determine further the prognostic significance of the stem cell ploidy levels as determined by nuclear DNA quantitation, the authors separated the tumors into low ploidy (less than 3N) and high ploidy (greater than 3N) groups. Of the clinical Stage I and II neoplasms, low ploidy tumors had a better prognosis than high ploidy tumors of comparable stage. Low ploidy tumors had a better prognosis than high ploidy tumors irrespective of the degree of differentiation. Mixed carcinomas had a poorer prognosis than pure adenocarcinomas of comparable clinical stage. This might be explained by the greater proportion of high ploidy stem cells in mixed carcinomas than in pure adenocarcinomas. Although advanced clinical Stage III and IV neoplasms had a poor outlook regardless of the DNA ploidy level, there was a proportional increase of high ploidy tumors with increasing clinical stage. These findings suggest that cervical granular neoplasms having high ploidy stem cell lines are biologically more aggressive than those with low ploidy stem cell lines.