PREDICTIVE VALUE OF PROLIFERATION-RELATED MARKERS, P53, AND DNA-PLOIDY FOR SURVIVAL IN PATIENTS WITH SOFT-TISSUE SPINDLE-CELL SARCOMAS

In a retrospective study of 60 spindle-cell sarcomas of peripheral sof t tissues, we evaluated the extent of immunostaining with antibodies a gainst Ki-67, proliferating cell nuclear antigen, and p53 protein and flow-cytometric DNA ploidy, their relation to tumor location, depth, h istologic type, size, mitotic rate, and extent of tumor necrosis, as w ell as their influence on survival, Although Ki-67-labeled nuclei were detected in only 41 tumors (68%) and their number varied from 1 to 50 %, proliferating cell nuclear antigen immunoreactive nuclei were found in each tumor, with their number ranging from 20 to 99%, p53 Protein was found in 26 cases (43%), and its labeling ranged from 1 to 80%, Al though Ki-67 labeling significantly correlated with mitotic rate, no c orrelation could be found between proliferating cell nuclear antigen o r p53 labeling and any other variables studied, Thirty-eight percent o f the tumors were diploid, and 64% were aneuploid, Factors that signif icantly reduced survival in univariate analysis were increasing size a nd depth of the tumor, the presence of necrosis, the National Cancer I nstitute grade, and a tetraploid/hypertetraploid DNA pattern, In multi variate analysis of 49 cases with complete information, only DNA ploid y pattern, tumor size, and tumor necrosis retained their independent p rognostic significance.