DNA Content and histologic growth pattern correlate with prognosis in patients with advanced squamous cell carcinoma of the larynx

Abstract

Background. Alterations in DNA content, nuclear morphologic characteristics, and histologic grading have been associated with prognosis in several types of solid malignant neoplasms. Methods. To determine the potential usefulness of these factors in predicting tumor behavior in patients with laryngeal squamous cell carcinoma, tumor specimens from 88 previously untreated patients with Stage III or IV cancers were studied. The DNA content and nuclear area (NA) were measured for individual nuclei of each tumor with the use of Azure A‐stained frozen sections. An adjusted DNA index (aDI) for each patient was calculated from the slope of the linear regression analysis of nuclear DNA index on NA. Hematoxylin and eosin‐stained sections were examined and graded systematically for histologic growth pattern. All patients were enrolled in a prospective clinical trial and had laryngectomy and postoperative radiation therapy. Results. The disease‐free survival length was longer and the relapse rates were lower in patients with a low aDI (P < 0.005) and with tumors exhibiting low‐grade growth patterns (P < 0.001). Conclusions. These parameters were independent of staging variables and were better predictors of tumor relapse than traditional clinical staging classifications.

An immunohistochemical study of cyclin D1 protein expression in laryngeal squamous cell carcinoma

“…A particularly important variable within this classification scheme offering most information concerning prognosis is the presence of lymph node metastases [20]. In our sample, we found that the presence of adenopathies correlated significantly with a worse prognosis, corroborating the findings of other studies [21]. Moreover, statistically significant differences in survival were also found among clinical stages I to IV.…”

Immune Reactivity Does Not Predict Chemotherapy Response, Organ Preservation, or Survival in Advanced Laryngeal Cancer

“…However, these findings are consistent with other prior results from the VA Laryngeal Cancer Study, which demonstrated better outcome with chemoradiation in patients with cancers having biological markers of aggressive behavior such as increased DNA content, high PCNA expression, overexpression of p53, or aggressive histological growth pattern. 8–10 Because of the consistency of these results, a theme is emerging that combined chemoradiation may be most effective in patients with aggressive, rapidly proliferating, highly invasive tumors that are not typically treated well with primary surgery. Likewise, tumors with markers of indolent growth, low proliferation, or limited invasion might best be managed with conservative simple excisions, sometimes even allowing functional organ preservation.…”

Morphometry of the basal cell layer of oral leukoplakia and oral squamous cell carcinoma using computer-aided image analysis

“…[23] noted that nuclear DNA content and nuclear area were better indicators of the biologic aggressiveness of cancer in laryngeal cancers. In the study by Jin et al .,[24] the mean±SD of N:C ratio of islands of invasive SCC was 0.650±0.207.…”