Laser DNA-flow cytofluorometry in the differential diagnosis and prognosis of the cervix uteri cancer

摘要

Laser DNA-flow cytofluorometry (DNA-FC) was used to examine 102 primary patients with morphologically verified pathology of the epithelium of the cervix uteri. There was a significant reduction in the count of cells in the cellular cycle phase (CCP) G0/1 and its increase in the CCP S and G2 + M, as well as a rose in the cell proliferation index (PI) in actually invasive (n=45) and microinvasive cancer of the cervix uteri (CCU) (n=21) as compared with the baseline values (n=8), CIN I-II (n=7), and CIN III (21 patients with severe dysplasia and cancer in situ; their DNA-FC parameters were close and significantly indistinguishable). With unfavorable clinical and morphological factors of CCU prognosis (age over 50 years, postmenopause, stages II-III, high-grade tumor, more than 3 mm stromal invasion, more than 4 cm in size, lymphovascular invasion in the regional lymph nodes, the endophytic form of growth, and a primary focus in the endocervix), aneuploid tumors were more significantly frequently found. The poor CCU prognostic factors significantly decreasing total and relapse-free 4-year survival included tumors of aneuploid type, those containing greater than 40% of aneuploid cells, those containing less than 70% of tumor cells in CCP G0/1, those having 10% of tumor cells or more in CCP S or more than 30% cell PI. While predicting CCU, the DNA index (DNAI) and PI with 0.09 and 0.05 informative value coefficients, respectively are the most significant DNA-FC parameters (after Shenon). By using them, the risk of progressive disease may be predicted with 67.9% probability. When DNAI and PI are used in combination with the most significant clinical and morphological factors of CCU, the likelihood of the latter increases up to 89.3%.