Prognostic significance of flow cytometric DNA analysis in patients with malignant pleural mesothelioma

Malignant pleural mesothelioma (MPM) due to environmental exposure to asbes tos and erionite is a relatively common cancer in Turkey. In this study, we investigated the value of flow cytometric (FCM) DNA analysis and other pro gnostic factors such as age and etiologic factor in the patients with MPM, treated with surgery combination chemotherapy radiotherapy. A total of 40 p atients with a median age of 50 (range 30-68) were included in the Study. T wenty-nine patients had asbestos exposure in etiology, while 11 had fibrous zeolite (erionite). Paraffin-embedded tumor specimens were studied by FCM for DNA analysis. Twelve patients (30%) had aneuploid tumors and 28 (70%) h ad diploid ones. Mean S-phase fraction (SPF; %) was 9.1 +/- 1.1 and prolife ration index (PI, SPF + G2/M phase; %) was 11.3 +/- 0.9. While the median o verall survival (OS) was 10 +/- 2 months (6-14; 95% Q, 1-year survival rate was 45.2%, Only PI was found to be statistically significant for OS in uni variate analysis (P = 0.013). PI was also found to be an independent progno stic factor for all patients (P = 0.035). Aneuploidy was significantly high er in erionite group Compared with asbestos group. Male predominance and po or survival were also prominent in erionite group, though not statistically significant. In conclusion, PI is an independent prognostic factor for pat ients with MPM and the biologic features of the disease may show difference s with respect to different etiologies. (C) 2001 Elsevier Science Ireland L td. All rights reserved.