DNA analysis of laryngeal carcinoma cells by flow cytometry: The histoclinical factors and their significance

In patients suffering from several types of malignant rumours, changes in d eoxyribonucleic acid (DNA) content are usually associated with poorer survi val prognosis. In the present study, DNA content and clinical and histopath ologic features were analyzed in patients suffering from laryngeal carcinom a, with a view to establishing the crucial prognostic factors. In the 5-yea r follow-up study, flow cytometry was used to analyze DNA content in the pa raffin-embedded samples of laryngeal carcinoma tissue obtained from 90 pati ents who had undergone surgical treatment in the Department of Otolaryngolo gy, Collegium Medicum, Jagiellonian University, Cracow, Poland, in 1987 and 1988. The group consisted of 59 and 31 patients with T3 and T4 rumours, re spectively. In each case, neck dissection was carried out either on one or both sides. Metastases in regional lymph nodes were found in 26 patients. T he disease-free 5-year survival rate was 55.6%. Among the investigated in r egional lymph nodes were found In cases, there were 14 aneuploid and 76 dip loid rumours. The treatment yielded the worst results, when the S-phase fra ction (SPF) and proliferative index (PI) were equal to or higher than 15.8% and 16.0%, respectively. The values of SPF and PI index did not correlate, however, with the frequency of regional metastases. Univariate analysis re vealed that tumour size (T stage), presence of lymph node metastases, age o f patients (less than or equal to 60, >60), tumour differentiation, tumour front grading (<15 points, <greater than or equal to>15), mode of infiltrat ion, SPF, and PI were positively correlated with the actual survival rate. Presence of lymph node metastases (p = .0001) and the PI (p = .0067) were f ound to be the only independent prognostic factors when the Cox multivariat e analysis was applied. The assessment of the PI by flow cytometry may effe ctively facilitate the selection of patients recommended for a more aggress ive treatment.