Erste Ergebnisse der bildzytometrischen DNS-Analyse zur Beurteilung der Prognose beim papillaren Schilddrüsenkarzinom

Summary

In this study we analysed DNA-ploidy as a potential prognostic parameter in papillary thyreoid carcinoma. Paraffin embedded histological material, obtained by resection from 19 patients with a papillary thyreoid carcinoma, was selected for analysis. Tumor areas within the paraffin-embedded material were identified by HE-stained reference sections. One 50 pin section was dewaxed, rehydrated and mechanically and enzymatically prepared to form a suspension of 10,000 cells/ml. 1 ml of the suspension, which contained bare nuclei with small rests of cytoplasma, was centrifuged on glass slides. The fixed nuclei were air-dried and stained by Feulgen SITS technique, which allows for the quantitative measurement of DNA. The DNA analysis was carried out with a computer-controlled single-cell cytophotometry. In contrast to using flow cytometry, only the tumor cells were measured by image-cytometry. Overlapping nuclei, dirt and other artifacts as well as inflammatory cells were efficiently eliminated. With DNA image-cytometry, we could differentiate between diploid (n = 13) and aneuploid (n = 6) tumors. Best prognosis with a survival rate of 92% after 103 months had patients with diploid tumors in contrast to patients with aneuploid tumors who did not survive more than 72 months.

Zusammenfassung

Bei 19 Patienten, bei denen wegen eines papillären Schilddrüsenkarzinomes eine Resektion durchgeführt worden war, wurde neben der TNM-Klassifikation und den üblichen morphologischen Beurteilungskriterien zusätzlich eine bildanalytische DNS-Zytometrie durchgeführt. Es fanden sich 13 diploide and 6 aneuploide Tumoren. Bei Patienten mit diploiden Tumoren betrug die rezidivfreie Überlebensrate Bowie die Überlebensrate nach 103 Monaten 84% bzw. 92%, wäh-rend 3 von 6 Patienten mit nichtdiploiden Tumoren in nerhalb von 70 Monaten ein Rezidiv erlitten. Zwischen dem DNS-Gehalt der Tumoren einerseits and dem Tumorstadium, der pT-Einteilung, dem Vorhandensein von Lymphknotenmetastasen and einer tumorbedingten Gefäβinfiltration andererseits fand sich kein Zusammenhang.