NUCLEAR-DNA CONTENT AND MORPHOLOGICAL-CHARACTERISTICS IN THE PROGNOSIS OF ADRENOCORTICAL CARCINOMA

Prognostic factors are needed for the management of patients with adre nocortical tumours. For this reason, the nuclear DNA content of patien ts with adrenocortical tumours was analysed by flow cytometry. The rel ationships between nuclear DNA content, histological indices, and clin ical parameters were studied. DNA ploidy could be evaluated in 54 carc inoma and 31 adenoma patients. Twenty-one (68%) of the adenomas, and 6 (11%) of the carcinomas, were DNA diploid. Hypo/Hyperdiploidy was fou nd in 5 (16%) of the adenomas, and 15 (28%) of the carcinomas. The rem aining patients had a DNA index above 1.40. A shorter survival was fou nd in patients with diploid carcinomas (P<0.05). A longer disease-free survival was seen in patients with hypo/hyperdiploid carcinomas (P<0. 05). Nuclear DNA content was not related to the histological index, no r to clinical parameters. We conclude that nuclear DNA content is rela ted to (disease-free) survival of patients with adrenocortical carcino mas. An adenoma-carcinoma sequence may be present in the adrenal corte x. In adrenocortical tumours ploidy evolution appears to be different than that observed in other solid tumours.