FLOW CYTOMETRIC DNA ANALYSIS OF FRESH PROSTATIC RESECTIONS - CORRELATION WITH CONVENTIONAL PROGNOSTIC PARAMETERS IN PATIENTS WITH PROSTATE-CANCER

Background. DNA ploidy analysis has been investigated as a prognostic indicator in prostate cancer. Most of the data is derived from retrosp ective studies using paraffin-embedded tissue. This method has drawbac ks related to the quality of DNA histograms and uncontrolled data coll ection. Methods. DNA ploidy analysis of freshly resected prostatic tis sue was prospectively compared with conventional prognostic variables in 97 men treated with radical prostatectomy for localized prostate ca ncer. Results. Regarding the patients, 31.9% were African American and 66% had pathologic Stages C or D1 disease. Only 9.6% of patients with Stages A2 and B had a prostate-specific antigen (PSA) value greater t han 10 ng/ml, whereas 97% of patients with PSA values greater than 20 ng/ml had pathologic Stages C and D1. PSA levels correlated with Gleas on score (P = < 0.05); 51% and 100% of patients with Gleason score 5-7 and 8-10, respectively, had PSA values greater than 10 ng/ml. Twenty- two patients (23%) had DNA aneuploid tumors. Comparisons of mechanical to enzymatic cell suspensions indicated that DNA aneuploidy was bette r preserved in mechanical cell preparations. DNA ploidy correlated wit h pathologic stage (P = < 0.05) and Gleason score (P = < 0.05). Fiftee n of 79 patients (18.9%) with Gleason score 5-7 had DNA aneuploid tumo rs versus 71.4% of patients with Gleason score 8-10. PSA groups correl ated with ploidy status (P 0.01). Although the majority of patients (1 9 of 22) with DNA aneuploid tumors had elevated preoperative PSA level s, none had a PSA value greater than 50 ng/ml. Conclusions. DNA ploidy analysis correlated with established prognostic indicators in prostat e cancer; however, its independent correlation with natural history an d treatment outcome must be established for it to have an effect on th erapeutic decisions.