The prognostic significance of DNA ploidy in laryngeal cancers

Yıl 2002, Cilt: 9 Sayı: 6, 414 - 423, 20.12.2002

Timur Akçam Abdullah Akkaya Yalçın Özkaptan Mustafa Gerek Salih Deveci Önder Öngürü

Öz

Objectives: We assessed the relationship betvveen DNA ploidy and histopathologic parameters and its effect on prog- nosis in patients with squamous celi carcinoma of the larynx.Patiaıts and Methods: Surgical sections of 44 patients who were treated for squamous celi carcinoma of the larynx were studied. Image cytometry measurements were performed on nuclear suspensions derived from paraffin-embedded sec­ tions to determine DNA ploidy patterns. We investigated the relationship betvveen the DNA ploidy status and localization, stage, differentiation, keratinization, depth of tumoral invasion, lymphocytic infiltration, perineural invasion, infiltration pattern, necrosis, and 5-year and overall survival rates.Results: Aneuploidy and diploidy were diagnosed in 65.9% and 34.1%, respectively. No significant relationships were found betvveen DNA ploidy and stage, localization, differentia­ tion, keratinization, depth of invasion, infiltration pattern, lym­ phocytic infiltration, necrosis, perineural invasion, and lymph node metastasis p>0.05 . The five-year p=0.048 and over­ all log rank=4.40; p=0.036 survival rates were significantly higher in diploid tumors. The presence of perineural invasion p=0.004 and depth of the invasion exceeding 9 millimeters p=0.045 were significant factors adversely influencing the five-year survival rate. The multivariate Cox regression analy- sis shovved that the DNA ploidy status p=0.042 and the pres­ ence of perineural invasion p=0.009 were independent prog­ nostic variables related to decreased survival.Conclusion: Aneuploidy has an adverse effect on the prognosis in squamous celi carcinoma of the larynx.

Anahtar Kelimeler

Aneuploidy, carcinoma, squamous cell/pathology/ genetics/radiotherapy, DNA, neoplasm/analysis, diploidy, head and neck neoplasms/genetics, image cytometry, laryngeal neoplasms/ pathology/genetics, lymphatic metastasis, neoplasm recurrence, local, ploidies, prognosis, survival analysis

Larenks kanserlerinde DNA ploidinin prognostik önemi

Öz

Amaç: Yassı epitel hücreli larenks kanseri olan olgulardaDNA ploidinin, tümöre ait özellikler ve histopatolojik parametreler ile iliflkisi ve prognoz üzerine etkisi arafltırıldı.Hastalar ve Yöntemler: Çalıflmada yassı epitel hücrelikanser nedeniyle tedavi edilip izlenen 44 olgunun cerrahikesitleri incelendi. Parafin bloklardan elde edilen nükleussüspansiyonlarında görüntü analizi tekniği ile DNA ploidiarafltırması yapıldı. DNA ploidinin tümör yerleflimi, evre,diferansiasyon, keratinizasyon, invazyon derinliği, lenfositinfiltrasyonu, perinöral invazyon, infiltrasyon türü, tümörnekrozu, befl yıllık sağkalım ve yaflam süresi ile iliflkisi değerlendirildi.B u l g u l a r : Olguların %65.9’unda anaploidi, %34.1’inde diploidi belirlendi. Tümör evresi, yerleflimi, diferansiasyon, keratinizasyon, invazyon derinliği, invazyon türü, lenfosit infiltrasyonu, tümör nekrozu, perinöral invazyon ve lenf nodu tutulumu ile DNA ploidi arasında anlamlı iliflki görülmedi p>0.05 . Diploid tümörlerde befl yıllık sağkalım p=0.048 ve genel sağkalım log rank=4.40; p=0.036 oranlarıanaploid tümörlere göre anlamlı düzeyde yüksek bulundu.Perinöral invazyon varlığı p=0.004 ve invazyon derinliğinin9 mm’nin üzerinde olması p=0.045 befl yıllık sağkalımı anlamlı düzeyde düflüren diğer faktörler olarak değerlendirildi.Cox regresyon analizi sonucunda DNA ploidi p=0.042 veperinöral invazyonun p=0.009 sağkalımı etkileyen bağımsız prognostik faktörler oldukları görüldü.Sonuç: Anaploidi varlığı, yassı epitel hücreli larenks kanserli olgularda prognozu olumsuz etkilemektedir

Anahtar Kelimeler

Anaploidi, karsinom, skuamöz hücreli/patoloji/genetik/radyoterapi, DNA, neoplazm/analiz, diploidi, bafl-boyun neoplazmları/genetik, görüntü sitometrisi, larenjeal neoplazmlar/patoloji/genetik, lenfatik metastaz, neoplazm nüksü, lokal, ploidi, prognoz, sağkalım analizi

Kaynakça

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