THE ROLE OF DNA FLOW-CYTOMETRY IN BORDERLINE MALIGNANT OVARIAN-TUMORS

BACKGROUND. The role of flow cytometric DNA analysis in predicting pro gnosis of patients with borderline malignant ovarian tumors has been c ontroversial. METHODS. Fifty cases of patients with borderline maligna nt ovarian tumors were analyzed by histology and by flow cytometry on paraffin embedded tissue. Multiple tissue blocks and serial sections w ere analyzed for each tumor. The results of DNA analysis were correlat ed to clinicopathologic data. RESULTS. DNA aneuploidy was demonstrable in 4 cases (8%) when the most atypical section was analyzed. The over all rate of aneuploidy was 14% if additional blocks and serial section s were studied. Two patients died from tumor. One of the two patients had an initial diagnosis of Stage IIc mucinous borderline tumor with D NA indices (DI) of 1.12, 1.42, and 2.04. She had a recurrence in the c ontralateral ovary 1 year later (DI = 1.83), and a second frankly mali gnant recurrence diffusely in peritoneum (DI = 1.89). The other patien t had an initial diagnosis of Stage IIIc mucinous borderline ovarian t umor with pseudomyxoma peritonei. DNA diploidy was obtained in all of the samples from the primary tumor. An aneuploid peak (DI = 1.28) was demonstrated in only one serial section of the peritoneal implants. Of the other 5 patients who had aneuploid histograms but were disease-fr ee, the DNA indices were 1.35, 1.14/1.18, 1.15, 1.20, and 1.31 and wer e demonstrable only in either 1 or 2 of the blocks or unproven on seri al sections. All patients with diploid-peridiploid tumors were alive a nd disease free. CONCLUSIONS. Reproducible DNA aneuploidy of high DI m ay be predicting a poor outcome, whereas the significance of inconsist ently reproducible aneuploidy of low DI remains to be determined. Furt her studies of prospective DNA analysis with adequate sampling are nec essary to define the role of flow cytometry in patients with borderlin e malignant ovarian tumors. (C) 1996 American Cancer Society.