Pre- and Postoperative DNA Ploidy Patterns Correlated to Pt-Stage, Histological Grade and Tumour Volume in Total Prostatectomy Specimens

Abstract

Fifty-four consecutive patients with a preoperative diagnosis of localized prostatic cancer underwent total retropubic prostatectomy. The specimens were step-sectioned at 5 mm intervals. Volumes of invasive cancer (IC) and prostatic intraepithelial neoplasia (PIN) were calculated by computerized planimetry. From preoperative core and fine needle aspiration biopsies and from each prostatectomy specimen, multiple samples were taken from IC and PIN areas for DNA ploidy analysis. The study aimed to evaluate current biopsy sampling techniques as regards their suitability for DNA analysis and to assess the heterogeneity of DNA-ploidy and correlate the latter to postoperative pT-stage and tumour volume. When compared with the prostatectomy specimens, the preoperative assessment of non-diploid DNA patterns in biopsies had a sensitivity of 62% and a specificity of 86%. Samples from 24 surgical specimens contained non-diploid DNA in the main tumour and in one or several of the satellites. However, all these cases also contained diploid cell lines, both in the main tumour and in one or several of the satellites. Tumours with a volume exceeding 12 cc:s were non-diploid in 87.5% of cases (7/8). Tumours with volumes between 8 and 12 cc:s contained non-diploid foci in 50% of cases (2/4). Tumours smaller than 2 cc:s were non-diploid in 18% of cases (2/11). All non-diploid tumours were moderately or poorly differentiated. Of the non-diploid tumours, 96% (23/24) displayed capsular penetration versus 57% (17/30) of the diploid tumours (p < 0.0001). All PIN samples were made up of diploid cell lines.(ABSTRACT TRUNCATED AT 250 WORDS)

DNA Ploidy Patterns in Androgen-Deprived Localized Prostate Cancer

“…Only a few cases showed aneuploidy. However, high CV values may mask the existence of near-diploid or neartetraploid aneuploid cells [29,30], For this reason and in accordance with the findings in our previous study [25], all DNA ploidy patterns have been classified into diploid and nondiploid, although strictly speaking it might be more cor rect to divide them into near-diploid and near-tetraploid.…”

“…The 30% increase in tu mors with a nondiploid DNA ploidy pattern may be due to therapy or to an underestimate of the DNA ploidy aber ration in the core needle biopsy specimens because of het erogeneous DNA ploidy patterns in the tumors. In accor dance with the latter suggestion, a similar discrepancy between preoperative needle biopsies and prostatectomy specimens was observed in patients having localized pros tate cancer operated on without having undergone hor mone ablation [25], A comparison of DNA ploidy patterns in prostatecto my specimens obtained in this and the previous study [25] might well reveal some effect of preoperative hormone treatment. The patients were of the same age and were not on treatment with cytotoxic drugs.…”

“…Samples within the ratio 1.90-2.10 were regarded as diploid, provided that the G2 + M peak did not exceed 10% of the total number of nuclei. This level was chosen in accordance with our previous study [25]. Peaks above this level or outside the ratio 1.90-2.10 were regarded as nondiploid.…”

DNA-cytometric grading of prostate cancer Systematic review with descriptive data analysis

“…• 8 level 1b studies reported a significant correlation of DNAcytometric features with histologically proven cancer spread beyond the capsule as detected after radical prostatectomy [167][168][169][170][171][172][173][174]. 4 of them document a significant improvement of diagnostic accuracy concerning the prediction of organ confinement by DNA-ploidy features over Gleason-score alone ( Table 3).…”

“…The fact that DNA-ploidy-parameters are able to nearly exclude cancer spread beyond the capsule as detected after radical prostatectomy significantly more precise than the Gleason-Score, has been proven in 8 level 1b studies [167][168][169][170][171][172][173][174], Table 3. Thus DNA-ploidy should additionally be taken into consideration, whenever organ confinement is a prerequisite for certain therapeutic strategies, like AS.…”