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Analytical Cellular Pathology
Volume 16, Issue 4, Pages 223-231

DNA Aneuploidy by Flow Cytometry Is an Independent Prognostic Factor in Gastric Cancer

Mar Abad,1 Juana Ciudad,4 Manuel R. Rincon,3 Isabel Silva,2 José I. Paz-Bouza,1 Antonio Lopez,4 Alberto G. Alonso,2 Agustin Bullon,1 and Alberto Orfao4

1Department of Pathology, University Hospital, Salamanca, Spain
2Department of Surgey, University Hospital, Salamanca, Spain
3Unit of Gastroenterology, University Hospital, Salamanca, Spain
4Servicio de Citometria, Universidad de Salamanca, Salamanca, Spain

Received 13 October 1997; Accepted 14 April 1998

Copyright © 1998 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


In the present study the prognostic value of both DNA ploidy and the proliferative activity of tomour cells were studied in a series of 76 consecutive patients suffering from gastric tumours. DNA ploidy and the proliferative index (as measured by the percentage of S-phase cells) were determined by flow cytometry using fresh tumour specimens.

The presence of DNA aneuploid clones by flow cytometry was detected in 62% of the cases (mean DNA index of 1.63 ± 0.46; range 1.08–2.92), the mean proportion of S-phase cells being of 18.4 ± 11.5%. In comparison with diploid cases, aneuploid tumours showed a higher proliferative activity (cases with more than 15% S-phase cells: 18.4% versus 6.1%, p = 0.0001) as well as a higher incidence of node involvement (95% versus 68%, p = 0.001). By contrast, no significant differences were detected with respect to sex, age, histologic grade and type, clinical stage, tumour size and the incidence of extranodal involvement.

Upon grouping the patients according to the proportion of S-phase cells no significant differences were observed for the clinical and biological parameters explored except for an association between a high percentage of S-phase cells and the presence of DNA aneuploidy (40% versus 96%, p = 0.0001). Regarding survival the presence of DNA aneuploidy was significantly associated with poor outcome as compared to the diploid cases (median of 15 versus 26 months, p = 0.005). By contrast, the proportion of S-phase cells did not predict patients’s outcome.

Multivariate analysis of prognostic factors showed that the presence of DNA aneuploidy (p = 0.003) together with the histologic type (p = 0.03) and the existence of extranodal metastases (p = 0.05) were the best combination of prognostic factors for survival prediction.