Prognostic significance of cellular ploidy and labeling index in resected gastric cancer

M. Montorsi, A. Poggio, G. C. Roviaro, U. Fumagalli, A. M. Lavezzi, G. Torzilli, S. Bona, L. Matturri, G. Pezzuoli

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Abstract

The aim of this study was to evaluate the prognostic significance of cellular ploidy and proliferative activity (labeling index: LI) in 32 gastric adenocarcinomas resected in the years 1986-1990 and staged according to the Japanese Research Society for Gastric Cancer Study. Cellular DNA content was determined with histospectrophotometric analysis. Cellular kinetics was determined by in vitro, autoradiographic analysis with H3 thymidine. The histograms of DNA content were divided into two groups according to the Haraguchi classification (tumors with less 10% cells with DNA > = 6C; tumors with more 10% cells with DNA > = 6C). The neoplasms were divided into two groups on the basis of their LI: the median LI value of the 32 cancers, 11%, was used as cut-off value (low LI <11%; high LI > 11%). No significant correlation was found between LI and involvement of serosa, extent of nodal metastases and grading of neoplasm. Eight tumors (73.5%) among the 11 high ploidy cancers showed nodal metastases. Fifteen patients out of 16 with low-ploidy tumors underwent a curative resection. The actuarial survival at 30 months was 59.9% in low ploidy group, 0% in the high ploidy group (p = ns). The actuarial survival rate at 30 months was 67% in the low LI group while it was 45.8% in the high LI group. The combined analysis of ploidy and LI allowed to define two groups with similar distribution of pathologic staging: group A with both low ploidy and low LI in which, in a 20 months follow-up period, only 2 patients (28.5%) had a cancer recurrence; group B, patients with high ploidy and high LI, where 6 patients had a cancer recurrence (85.7%). Our study showed no significant correlation of ploidy and LI with traditional prognostic markers; independent analysis of ploidy and LI survival rates seems to demonstrate a prognostic value for these markers. Grouping of tumors on the basis of both factors may help to identify a subgroup of aggressive cancers, unrelated to pathologic staging.

Original languageEnglish
Pages (from-to)657-662
Number of pages6
JournalChirurgia
Volume3
Issue number12
Publication statusPublished - 1990

ASJC Scopus subject areas

  • Surgery

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    Montorsi, M., Poggio, A., Roviaro, G. C., Fumagalli, U., Lavezzi, A. M., Torzilli, G., Bona, S., Matturri, L., & Pezzuoli, G. (1990). Prognostic significance of cellular ploidy and labeling index in resected gastric cancer. Chirurgia, 3(12), 657-662.