GASTRIC DNA CONTENT IN POSTGASTRECTOMY PATIENTS - RELATIONSHIP TO MUCOSAL DYSPLASIA

BACKGROUND. Gastric mucosal cellular DNA content was assessed in patie nts who had undergone gastric surgery for peptic ulcer disease more th an 20 years previously, with the aim of examining the relationship bet ween abnormal DNA content and gastric mucosal dysplasia, as well as de termining the effect of different types of surgery on DNA content. MET HODS. Sixty-five subjects underwent upper gastrointestinal endoscopy. In each, six biopsies were taken from the stoma or antrum and graded f or severity of dysplasia. Cellular DNA was quantified using a micropro cessor-controlled image analysis system with a fast densitometer card on Feulgen-stained slides. DNA histograms were evaluated using the 2c deviation index (2cDI) for proliferative activity and the 4c exceeding rate (4cER) and the 5c exceeding rate (5cER) as indices of malignant potential. RESULTS. In subjects with Billroth II operations, all the a bove DNA criteria were higher than in Billroth I (P < 0.05), vagotomy and pyloroplasty (P < 0.001), and controls (P < 0.0001). DNA values in creased as dysplasia progressed in severity (2cDI, Rs = 0.67; 4cER, Rs = 0.61; ScER, Rs = 0.72; respectively, P < 0.0001). Among subjects wi th no dysplasia, more aneuploid cells were found in the Billroth II gr oup, (p < 0.005) compared with the other types of operation. CONCLUSIO NS. Cellular DNA content is abnormal at an early stage in dysplasia an d may even predate it. Increasing values of abnormal DNA content are r elated to the severity of dysplasia. DNA analysis may be a useful addi tional tool in surveillance programs to select high-risk patients for screening. (C) 1996 American Cancer Society.