Abstract
The relationship between DNA ploidy and clinical prognosis was determined in 65 patients who underwent gastroectomy for early gastric cancer. Of the 65 patients, 16 had intramucosal and 49 submucosal tumours. Five-year survival rates were 100 and 79.6% for patients with intramucosal and submucosal tumours respectively. Diploid tumours were observed more frequently among the patients with intramucosal neoplasms. Among the patients with submucosal invasion, the presence of polyploid cells (greater than or equal to 6c) in less than 10% of the malignant population was associated with a superior survival at 5 years, than those with greater than or equal to 10% of polyploid cells (92.1% vs. 36.3%). When the macroscopic type and the ploidy status were evaluated together, patients who had greater than or equal to 10% of cells with DNA greater than or equal to 6 c and a protruding type of tumour, had a 5 year survival rate of only 12.5%. Finally when factors such as the level of wall invasion, percentage of polyploid cells, type of histogram, and macroscopic type were evaluated by multiple regression analysis, macroscopic type and percentage of polyploid cells were the only significant prognostic factors. On the basis of these findings, the DNA ploidy pattern and the macroscopic type may be useful markers of patients who will develop recurrence.
Highlights
Of the 65 patients, 16 had intramucosal and 49 submucosal tumours
We report that patients with early gastric cancer and susceptible to recurrence can be identified from the pattern of DNA ploidy
In the patients with type D, two aneuploid peaks were observed (Figure 1). This division of DNA ploidy pattern in groups A, B, C and D corresponds to the classification proposed by Hattori et al (1984) who divided patients numerically, i.e., 4C .Ssss from to 4
Summary
The study included 65 patients with gastric cancer limited to the mucosa or submucosal layers of the stomach and followed for a minimum of 5 years. The cells were incubated in Hanks solution containing 0.1% ribonuclease type IT-A (Sigma, St Louis) for 30 min at 37°C. The mean value of 25 stromal lymphocytes was considered to represent the normal diploid content (2c), and the DNA of 100 malignant cells in each specimen was measured. The histograms of the gastric cancer being studied were divided into 4 different types of ploidy pattern (Hattori et al, 1984). In the patients with type D, two aneuploid peaks were observed (Figure 1). This division of DNA ploidy pattern in groups A, B, C and D corresponds to the classification proposed by Hattori et al (1984) who divided patients numerically, i.e., 4C .Ssss. The chi-square test was used in tables (significance level=5%)
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