T Junginger — Page 21 | PubMed Health

PubMedDate not supplied

The relationship between DNA content, clinicopathology and prognosis in enteropancreatic carcinoids.

BACKGROUND/AIMS: The clinical behavior of carcinoid tumors is sometimes difficult to determine from their histological appearance. The aim of the present study was to evaluate whether the DNA distribution pattern seen in carcinoid tumors can be correlated with histopathological parameters and the patient's clinical course and prognosis. METHODOLOGY: The paraffin-embedded material of 44 enteropancreatic tumors underwent deparaffinization, was rehydrated, and mechanically and enzymatically processed into a single cell solution. For evaluation of the DNA histogram, analysis was performed with the help of an automatic single cell cytophotometric study. RESULTS: A correlation was seen between the DNA content and tumor stage (p = 0.01), radicalness of surgery (p = 0.03), tumor localization (p = 0.02) and patient's age (p = 0.05). In univariate analysis, patient's age (p = 0.04), tumor localization (p = 0.03), tumor stage (p = 0.0001), radicalness of surgery (p = 0.0006) and DNA content (p = 0.01) influenced prognosis. In multivariate analysis including these parameters, only tumor stage had an independent influence on prognosis. CONCLUSION: The clinical relevance of DNA measurement in carcinoid tumors is still unknown.

Adult↗

PubMedDate not supplied

Prognostic relevance of histomorphological parameters and DNA content and their therapeutic consequences in esophageal carcinoma: a multivariate approach.

BACKGROUND/AIMS: Despite recent advances in surgical and multidisciplinary treatment, the prognosis for patients with esophageal carcinoma remains poor. The low prognostic accuracy of even surgical pathological TNM staging suggests that additional parameters would be useful in determining the prognosis. METHODOLOGY: We undertook a retrospective analysis of 115 patients who had undergone transhiatal and transthoracic esophageal resection due to squamous cell carcinoma of the esophagus. In addition to TNM classification and the usual morphological criteria, a quantitative DNS analysis using Image DNA cytometry was performed. At the time of DNA analysis, histomorphological parameters and survival time was not known. RESULTS: The main prognostic parameter was the curativity (R classification) of the operation. Using only patients who had had R0 resection, a multivariate analysis was performed. Parameters included: patient age; preoperative ASA classification; tumor localization; pN category; number of intra-thoracal lymph nodes removed; pT category; pM category; grading; lymphangiosis; ploidy; operative procedure, and the development of postoperative complications identifying the ploidy, and the depth of tumor infiltration of prognostically independent factors. CONCLUSIONS: In the case of a diploid or tetraploid DNA content, tumor resection is recommended even in the case of lymph node metastasis at the truncus coeliacus. Patients with a diploid or tetraploid tumor without distant metastasis and tumor stage pT1-pT3 may, after curative (RO) transthoracic resection with two-field lymph node dissection, have an advantage over patients having a transmediastinal procedure in terms of long-term follow up. In cases of aneuploid DNA content, tumor resection shows no advantage over palliative non-operative procedures. Preoperative radio- or chemotherapy may improve the prognosis of these patients.

Adolescent↗