Correlation of DNA ploidy and proliferative activity estimated by flow-cytometry to histologic grading and clinical staging of colorectal carcinoma

ABSTRACT

The tumor cell DNA content cell proliferation as determined by flowcytometry may provide an additional factor in the prognosis and therapy planning of colorectal carcinoma. This work tried to correlate these criteria to other histopathological prognostic factors in this common and morbid type of malignant tumor. Thirty cases of resected colorectal carcinoma and five cases of colonoscopy obtained carcinoma specimens were subjected to histopathological examination and DNA study by flowcytometry. The DNA index [DI] was not elevated with high tumor grade, but increased in the presence of perineural invasion. The proliferative index [PI] showed elevation in all cases and was highest with blood and lymph vessel invasion and in the presence of desmoplastic reaction. The S phase fraction [SpF] was also elevated. It is increased in adenocarcinoma more than in squamous cell carcinoma, with higher tumor grade and also with blood vessel invasion. It was concluded that the combined study of DI, PI and SpF of tumor cells in resected or endoscopy obtained specimens of colorectal carcinoma can be indicative of the tumor biologic behavior and help in therapy planning