The assessment of apoptosis in solid tumors is of interest because of its biological role in tumor evolution and response to therapy. A commonly used method for apoptosis measurement is the TUNEL 3 end-labeling technique, which has shown wide variations in results when applied to solid tumors. Thirty-one fine needle breast carcinoma samples were analyzed by fluorescent TUNEL assay and DNA content using image analysis and flow cytometry. Key terms: TUNEL assay; apoptosis; breast carcinoma; flow cytometry; image analysis Programmed cell death (apoptosis) results from a cascade of events in response to a variety of stimuli (1,2). This vital process plays an important role in normal cellular homeostasis, tumor cell dynamics, and response to anticancer therapies (3,4). The assessment of apoptosis is therefore of interest in the biological evaluation of tumor kinetics and in the potential prediction of clinical response to treatment.Several techniques to detect different events in the temporal sequence of this process have been developed and used to quantitate apoptotic cells (1,2,5). Methods to measure early changes in cell membrane permeability, phospholipid asymmetry, mitochondrial membrane potential, and caspase activation have been used to identify apoptotic cells in experimental systems. In contrast, studies of apoptosis in solid tumors have mainly utilized techniques that measure later events such as DNA fragmentation. Of these, the 3Ј end-labeling technique (TUNEL assay) appears to be the method of choice for many studies (6 -15).The majority of breast carcinoma studies have been histology-based TUNEL assays that use immunoperoxidase methods. These techniques are less sensitive than the corresponding fluorescence-based assays which, in addition, allow multiparametric analysis of DNA fragmentation with the quantitation of DNA content and cellular antigens or fluorescence in situ hybridization (FISH) using image analysis, laser scanning, or flow cytometry.In this study, we applied the fluorescent TUNEL assay to fine needle samples of breast carcinomas and compared the results obtained by flow cytometry and image analysis.
MATERIALS AND METHODSThirty-one fine needle samples from 30 primary breast carcinoma patients were prospectively acquired at the Institut Curie and formed the material for this study. Specimens were placed immediately into 1 ml RPMI 1640 (Sigma, St. Louis, MO) with 10% fetal calf serum (FCS;