Stage B prostate adenocarcinoma. Flow cytometric nuclear DNA ploidy analysis
B. T. Montgomery, O. Nativ, M. L. Blute, G. M. Farrow, R. P. Myers, H. Zincke, T. M. Therneau and M. M. Lieber
Department of Urology, Mayo Clinic, Rochester, MN 55905.
Over a 16-year period (1966 to 1981), 349 patients underwent radical
retropubic prostatectomy for pathologic stage B adenocarcinoma of the
prostate. Nuclear DNA content was measured by flow cytometry on available
archival material of 283 patients. Two hundred sixty-one patients (92%) had
high-quality histograms. The ploidy distribution was as follows: DNA
diploid, 177 (68%); DNA tetraploid, 74 (28%); and DNA aneuploid, 10 (4%).
The average follow-up was 9.4 years. At the time of follow-up, 53 patients
(20%) within the study group had developed tumor progression: 22 local, 23
systemic, and 8 both. The ploidy distribution of the population that
developed tumor progression was 27 DNA diploid (51%), 16 DNA tetraploid
(30%), and 10 DNA aneuploid (19%). This ploidy distribution is
significantly different from that found for the nonprogression group with
stage B disease. Overall, 31% of patients with DNA nondiploid tumors had
tumors that progressed compared with 15% of patients with DNA diploid
tumors. All (100%) DNA aneuploid tumors progressed. The DNA ploidy
distribution of all pathologic stage B prostate cancers differs
significantly from that found in more advanced stages (C and D1) previously
reported for the same time interval. However, the ploidy distribution of
stage B tumors that progressed closely resembles that of the stage C and D1
tumors. These results further support the working hypothesis that nuclear
DNA content has marked prognostic significance for patients with
adenocarcinoma of the prostate. It seems to us that analysis of ploidy by
flow or static cytometry will become an essential tool for treating
patients with localized prostate cancer.
