Flow cytometry and squamous cell carcinoma of the maxillary sinus: A possible prognostic indicator for multimodality intervention

Malignant tumors of the paranasal sinuses constitute less than 1% of all ma lignancies. Unfortunately, few prognostic factors have been identified rega rding the efficacy of interventional therapy. Patients with carcinoma of th e maxillary sinus frequently present with an advanced stage of disease and multimodality therapy is often proposed. Although some tumors appear to be more sensitive to preoperative chemotherapy and radiation therapy, a method of predicting and evaluating tumor behavior has not been recognized. Intro duced as a means of identifying cell populations with abnormalities in tota l DNA content, flow-cytometric DNA analysis provides a quick and reliable m eans of tumor characterization for many malignancies. Although nuclear DNA content has been implicated as a prognostic factor in an increasing number of tumor types, current data on the role of DNA content in head and neck ca rcinoma is conflicting and incomplete. To evaluate the role of flowcytometr ic DNA analysis in predicting therapeutic alternatives, 22 patients with sq uamous cell carcinoma of the maxillary sinus were reviewed. Patient outcome and histopathologic grade were retrospectively compared with flow-cytometr ic evaluations of paraffin-embedded formalin-fixed tumor specimens. Four of sixteen tumors (25%) were found to be aneuploid and were also associated w ith an increased survival rate (p < 0.01). This initial data emphasizes the possible usefulness of DNA measurement for characterization of squamous ce ll carcinoma of the maxillary sinus and stresses the need for further evalu ation.