Clinical relevance of tumor ploidy and micronucleus formation for oral cavity cancer

Aims and background: To study the clinical relevance of tumor ploidy and mi cronucleus formation as prognostic factors, Methods and study design: Twenty-eight patients with squamous cell carcinom a of the oral cavity were treated with primary radiochemotherapy consisting of irradiation up to 70 Gy in combination with cisplatin, Cell cycle distr ibution, micronucleus formation and ploidy were evaluated by flow cytometry of biopsies taken before treatment and after irradiation to 10 Gy (5 x 2 G y), Sexteen out of 28 patients relapsed after a minimum follow-up period of two years. Results: Flow cytometry of the recurrence biopsy showed hyperpentaploid (5c exceeding) cells in 13/16 (81%) of the relapsed patients. In 7 patients th e hyperploid clone was not present in the flow cytometry of the primary tum ors. Ploidy could retrospectively be determined also by image cytometry in archival tumor material of the pretreatment specimens. Patients with a leve l below 100 5c cells per 10,000 cell nuclei were shown to have a significan tly better prognosis than patients with more than 100 hyperpentaploid tumor cells. The micronucleus formation was 2-5 times higher in tumors showing a good response to treatment than in carcinomas relapsing within two years. Conclusions: The 5c-exceeding ratio measured by image cytometry and micronu cleus formation proved to be good prognostic parameters for the clinical ou tcome of patients with locally advanced head and neck carcinomas.