Significance of proliferative activity and DNA ploidy in pancreatic cancerand chronic pancreatitis

Background. Precise preoperative assessment of diagnosis and prognosis in p atients with pancreatic tumors would facilitate improvement of treatment st rategies. In this context, we evaluated the significance of the proliferati ve index and of static DNA cytophotometry in the diagnosis and prognosis of pancreatic tumors. Methods. Consecutive surgical specimens from 26 patients with ductal pancre atic cancers and eight patients with chronic pancreatitis were investigated by: 1. Staging; 2. Conventional histological and cytological grading; 3. MIB-1 (Ki-67 labeling) proliferating index; and 4. Static DNA cytophotometry. Results. All patients with chronic pancreatitis had a normal MIB-1 labeling index and a euploid DNA content. In contrast, patients with pancreatic can cers rarely had a normal labeling index (1 of 26 patients) or a euploid DNA content (6 of 26 patients). Staging significantly correlated with survival time. However, it did not correlate with cytological criteria. Cytological criteria, such as conventional grading, MIB-1 proliferating index, and DNA ploidy, were not significantly correlated with survival time. Conventional grading was significantly correlated (p < 0.02) with proliferating index, but not with DNA ploidy. Conclusion. Proliferating index and DNA ploidy are relevant cytological mar kers that can help to discriminate between chronic pancreatitis and pancrea tic cancer. The prognostic significance of these markers in pancreatic canc er patients, however, seems to be less relevant than tumor stage and of lim ited relevance for the individual cancer patient.