DNA analysis by flow cytometry(FACS) has been reported to be a useful prognostic technique for a cervix cancer. But study on the cervix cancer patients treated with neoadjuvant chemotherapy using flow cytometry has not been well known. The goal
of
this
study was to examine DNA patterns by flow cytometry as a potential prognostic factors for a cervix cancer treated with cisplatin bases neoadjuvant chemotherapy. At least two cycles of the neoadjuvant chemotherapy was done at stage Ib or IIa bulky
tumors(tumor diameter>3cm), and stage IIb or III tumors. After then, surgery including pelvic lymph-adenectomy was done at 27 patients who had complete or partial response on the chemotherapy.
Flow cytometric analysis was performed on paraffin-embedded tissue before chemotherapy and after surgery for the ploidy and cell cycle distribution. The DNA ploidy of the cells, cell cycle distribution, FIGO stage, pelvic lymph node involvement,
histologic type, age(40 years), tumor diameter(5cm), depth of the cervical invasion(1/2) after neoadjuvant chemotherapy were analysed in all patients. There were nine aneuploid tumors and eighteen diploid tumors before neoadjuvant chemotherapy on
the
flow cytometric analysis. The eight aneuploid tumor changed to diploid tumor after neoadjuvant chemotherapy, and the eighteen diploid tumor did not change their diploidy status. The S-phase fraction of the cells was higher in aneuploid tumor than
diploid tumors, and decreased after neoadjuvant chemotherapy.
There was no pelvic lymph node metastais at the anoadjuvant chemother and the eight pelvic lymph-node metastasis occured at the diploid tumor(pre-chemotherapy) This may suggest that the aneuploid tumor respond to chmotherapy more than the diploid
tumor
in terms of pelvic lymph-node metastasis. Multivariate analysis using the pre-chemotherapy S-phase fraction of the cells, histologic type, depth of the cervical invasion, FIGO stage, pelvic lymph node involvement, and tumor size(5cm) identify
that
the
pre-chemotherapy S-phase fraction of the cells was the predictor of recurrence after two years follow up.
In Conclusion, Pre-chemotherapy DNA ploidy sppears to be clinically useful predictor of pelvic lymph node involvement after neoadjuvant chemotherapy, and the pre-chemotherapy S-phase fraction of the cells appear to be clinically useful predictor
of
recurrence after two years follow up at cervical cancer patients treated with neoadjuvant chemotherapy and surgery. From the above results, it is considered that the aneuploid tumor may respond more to neoadjuvant chemotherapy than diploid
tumors,
and
have less pelvic lymph-node metastasis after neoadjuvant chemotherapy.
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