 Original Article
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Near tetraploid prostate carcinoma:
Methodologic and prognostic aspects
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| Gun Forsslund, M.D., Ph.D. 1, Bo
Nilsson, B.Sc. 2, Anders Zetterberg,
M.D., Ph.D. 1
* |
1Department of
Oncology-Pathology, Unit of Tumor Pathology, Karolinska Institute,
Stockholm, Sweden.
2Department of
Cancer Epidemiology, The Karolinska Hospital, Stockholm,
Sweden.
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*Correspondence to Anders Zetterberg,
Department of Oncology-Pathology, Unit of Tumor Pathology, Karolinska
Insitutet, Doktorsringen 16A, S-171 77 Stockholm, Sweden.
Funded by:
 Swedish Cancer Society
Cancer Society in Stockholm
Karolinska Institute
| prostate carcinoma • image cytometry • DNA ploidy • tetraploid
tumors • hormonal treatment • prognosis |
BACKGROUND |
| The clinical value of DNA ploidy analysis in prostate carcinoma
has been an issue for investigation for more than 2 decades. In
general, diploid or pseudodiploid tumors are associated with a
favorable prognosis and aneuploid tumors with an unfavorable
prognosis, irrespective of type of treatment. Tumors with DNA values
in the tetraploid region (around 4c) present a diagnostic problem.
Such DNA distributions may clearly represent aneuploid tumors with
an unfavorable prognosis. However, a 4c distribution may conversely
represent a tetraploid tumor (possibly a polyploid variant of the
diploid tumor) with a favorable prognosis. Previous data from our
laboratory indicate the existence of such a tetraploid subgroup. The
goal of the current study was to investigate the diagnostic problem
of 4c tumors in greater detail. |
METHODS |
| Ploidy classification of cytologic smears by image cytometry was
performed in a retrospective study of 334 patients with hormonally
treated prostate carcinoma. Follow-up time was 30 years or until
death. |
RESULTS |
| Three ploidy types were defined: near-diploid (D type),
near-tetraploid (T type), and highly aneuploid (A type). Tumors with
a modal value within the tetraploid region were found in 27% (92
cases) of the total material. Of these, 9% were defined as T type
and 18% as A type. Overall, 37% of the tumors were classified as D
type, 9% as T type, and 54% as A type. Of the A type tumors,
one-third had modal DNA values in the tetraploid (4c) region.
Multivariate analysis showed a statistically significant difference
between A type tumors and D and T type, but not between D type and T
type. Both D and T type tumors progressed slowly and killed the
patients 5 to 30 years after diagnosis, whereas A type tumors
progressed rapidly and killed the patients within 6 years of
diagnosis. |
CONCLUSIONS |
| By image cytometry, prostate carcinoma can be divided into three
ploidy types: D, T, and A type. Biologically, however, the tumors
fall into only two groups: low grade malignant, pseudodiploid tumors
of D or T type, and high grade malignant, highly aneuploid tumors of
A type. Cancer 1996;78:1748-55. |
Received: 1 April 1996; Revised: 26 June 1996; Accepted: 26 June 1996
10.1002/(SICI)1097-0142(19961015)78:8<1748::AID-CNCR15>3.0.CO;2-Y About
DOI
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