The use of flow cytometry to measure the DNA content from tumors has e
volved over the years. In squamous cell carcinoma arising in the head
and neck, there has not been uniform agreement in the literature, and
decisions regarding patient treatment cannot be made using this parame
ter. The use of proliferating cell nuclear antigen (PCNA), a newly ava
ilable marker of a cell's proliferative activity (S-phase fraction) is
also discussed. In a prospective series of patients, the findings of
diploidy, aneuploidy, low (PCNA) positivity, and high PCNA positivity
are compared to known biological parameters. Strong trends are shown d
emonstrating biological aggressiveness associated with aneuploidy, hig
h PCNA fraction, and the combination of aneuploidy and high PCNA fract
ion. The potential use of whole-cell preparation to determine ploidy a
nd PCNA fraction as a predictor of metastatic potential are discussed.
The whole-cell preparation technique allows accurate DNA ploidy measu
rements and, with the use of PCNA, a measure of proliferative activity
. These parameters combined with known TNM staging may 1. allow altera
tion in treatment and ultimately affect patient survival, and 2. allow
comparison of treatment modalities between biologically similar tumor
s.