FLOW-CYTOMETRY AS A PROGNOSTIC PREDICTOR IN GASTRIC LINITIS PLASTICA

Gastric linitis plastica (GLP) is a diffusely infiltrating carcinoma o f the stomach that is usually diagnosed in an advanced stage and assoc iated with poor prognosis. Recent studies to evaluate ploidy of these tumors are not conclusive. We undertook a retrospective study of 43 su rgically treated patients with GLP (27 males, 16 females, mean age 65 years) to see if ploidy could be used to predict outcome. Flow cytomet ric DNA analysis was performed on paraffin-embedded tissue using the m odified Hedley technique. Mean follow-up interval was 11 months (1-72 months) with 18 (42%) alive at end of study. The remaining 25 (58%) di ed with a mean survival of 7 months. Lymph node status was positive in 31 (70%) and negative in 12 (30%) of patients. Twenty-nine (67%) of t umors were diploid; 14 (33%) were aneuploid. Statistical analysis reve aled overall survival correlated significantly (P = 0.04) only with ly mph node status. Diploid tumors had 18 (60%) positive and 11 (40%) neg ative lymph nodes, whereas aneuploid tumors had 13 (93%) positive and 1 (7%) negative nodes. DNA content correlated significantly (P = 0.05) with lymph node status, but not with overall survival. Tumors with po sitive lymph nodes were 18 (51%) diploid and 13 (42%) aneuploid; tumor s with negative nodes were 11 (92%) diploid and 1 (8%) aneuploid. Conc lusions: The majority of GLP tumors manifest diploid characteristics, and the presence or absence of lymph node metastasis is a major determ inant in overall survival. (C) 1994 Wiley-Liss Inc.