RESUMEN
OBJECTIVE: To evaluate the association between ploidy and operability and prognosis in pancreatic cancer. DESIGN: Retrospective study. SETTING: Ullevaal Hospital and the National Hospital of Norway, Oslo. SUBJECTS: 148 patients with histologically verified pancreatic cancer diagnosed between 1980 and 1988. INTERVENTIONS: 29 patients had radical resections (18 Whipple procedures and 11 total pancreatectomies). Archival tissue was investigated in the blocks from these tumours, and from five patients who had only a biopsy taken, by DNA flow cytometry. RESULTS: 26/29 tumours excised radically had diploid DNA stemlines. Two of the three aneuploid stemlines were hyperdiploid, and the third was almost triploid. Among the five inoperable tumours, two were aneuploid and three diploid. The patients who underwent radical operations lived a median of 11.5 months (range 0-82), compared with a median of 4 months (range 0-58) for those whose tumours were inoperable. Six of the 29 patients were still alive without signs of recurrent disease 51.5 months (range 41-82) after operation. All but one of these tumours had diploid DNA stemlines, and synthesis (S) phase fractions below the median value for the whole group. CONCLUSION: DNA ploidy and S phase fraction are prognostic factors in pancreatic cancer.
Asunto(s)
Carcinoma Intraductal no Infiltrante/genética , ADN de Neoplasias/genética , Neoplasias Pancreáticas/genética , Ploidias , Anciano , Aneuploidia , Carcinoma Intraductal no Infiltrante/cirugía , ADN de Neoplasias/análisis , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/cirugía , Pronóstico , Estudios Retrospectivos , Fase S , Tasa de SupervivenciaRESUMEN
In 1976 endoscopy with at least 20 biopsies and cytology were performed in 108 patients 20-25 years after partial gastrectomy (Billroth II). In one patient advanced carcinoma and in three cases severe dysplasia or carcinoma in situ, were found. At the follow-study in 1979, 7 patients had died of causes other than gastric carcinoma. A re-examination with endoscopy, biopsies and cytology were performed in fifty-eight patients. The present study did not show a progress of dysplasia in the gastric remnant during the three years of follow-up. The observations may suggest that re-examinations with gastroscopy and multiple biopsies every 3-5 years may be satisfactory in detecting carcinoma of the gastric remnant.