TY - JOUR
T1 - Nephroblastoma. DNA characteristics and their modifications induced by prenephrectomy chemotherapy
T2 - A cytofluorimetric study
AU - Camassei, Francesca Diomedi
AU - Ferlini, Cristiano
AU - Jenkner, Alessandro
AU - Bosman, Cesare
AU - Biselli, Roberto
AU - Donfrancesco, Alberto
AU - Boldrini, Renata
PY - 2002
Y1 - 2002
N2 - Treatment of nephroblastoma (Wilms' tumor) has presently achieved a 90% survival rate. Stage and grade are considered the most reliable prognostic parameters, but other biological factors are under study in order to improve patient stratification. Deoxyribonucleic acid (DNA) ploidy has been suggested to be useful in this setting. We retrospectively studied 79 patients with nephroblastoma (58 pretreated with chemotherapy and 21 not pretreated) by means of flow cytometry. DNA content and synthetic phase values were correlated with pathologic features and outcome. DNA modifications induced by chemotherapy were investigated. Sixty-nine tumors were diploid and 10 aneuploid. DNA content did not correlate with clinical course and was not modified by pretreatment. Aneuploid tumors were restricted to lower stages. Mean S-phase rate was lower and did not vary according to histology in pretreated tumors, while it was higher and increased with grade (p = 0.007) in previously untreated tumors. The fraction of cells in synthetic activity was related to outcome: Patients whose tumors displayed higher S-phase rates had a more favorable clinical course. Ploidy did not appear to be of prognostic significance. S-phase rate decreased after chemotherapy (p = 0.0002) and was related to survival. The worse outcome of pretreated patients might be attributed to a minor sensitivity to postoperative treatment: Preoperative chemotherapy would decrease the cell proliferation and might select resistant cellular clones of (possible) neoplastic residues.
AB - Treatment of nephroblastoma (Wilms' tumor) has presently achieved a 90% survival rate. Stage and grade are considered the most reliable prognostic parameters, but other biological factors are under study in order to improve patient stratification. Deoxyribonucleic acid (DNA) ploidy has been suggested to be useful in this setting. We retrospectively studied 79 patients with nephroblastoma (58 pretreated with chemotherapy and 21 not pretreated) by means of flow cytometry. DNA content and synthetic phase values were correlated with pathologic features and outcome. DNA modifications induced by chemotherapy were investigated. Sixty-nine tumors were diploid and 10 aneuploid. DNA content did not correlate with clinical course and was not modified by pretreatment. Aneuploid tumors were restricted to lower stages. Mean S-phase rate was lower and did not vary according to histology in pretreated tumors, while it was higher and increased with grade (p = 0.007) in previously untreated tumors. The fraction of cells in synthetic activity was related to outcome: Patients whose tumors displayed higher S-phase rates had a more favorable clinical course. Ploidy did not appear to be of prognostic significance. S-phase rate decreased after chemotherapy (p = 0.0002) and was related to survival. The worse outcome of pretreated patients might be attributed to a minor sensitivity to postoperative treatment: Preoperative chemotherapy would decrease the cell proliferation and might select resistant cellular clones of (possible) neoplastic residues.
KW - Deoxyribonucleic acid (DNA) characteristics
KW - Nephroblastoma
KW - Outcome
KW - Ploidy
KW - Preoperative chemotherapy
KW - S-phase fraction
UR - http://www.scopus.com/inward/record.url?scp=0036160875&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036160875&partnerID=8YFLogxK
U2 - 10.1080/15227950252774129
DO - 10.1080/15227950252774129
M3 - Article
C2 - 11842975
AN - SCOPUS:0036160875
VL - 21
SP - 15
EP - 23
JO - Pediatric Pathology and Molecular Medicine
JF - Pediatric Pathology and Molecular Medicine
SN - 1522-7952
IS - 1
ER -