Abstract
There are few detailed reports on the heterogeneity of the nuclear DNA ploidy pattern in carcinoma of the gallbladder. We studied twelve autopsied cases who died of extended gallbladder carcinoma. Multiple samples were taken from the primary site (Pri), from direct invasion of the liver (Hinf), from hematogenous metastasis to the liver (H), from lymphatic metastasis (LN) and from peritoneal dissemination (P). The DNA ploidy pattern was investigated by image cytometry. Heterogeneity of the DNA ploidy pattern in Pri, Hinf, H, LN and P was found in 7/11, 2/10, 5/10, 2/6 and 3/6 cases, respectively. Aneuploidy was more frequently found in Hinf than at the Pri. The DNA index of Hinf was significantly higher than that of Pri. Several stcmlincs, with different quantities of DNA, were found in Pri. Most of these stemlines were also observed in other sites. These facts may suggest that polyclonal cancer cells rather than one cancer cell or monoclonal cancer cells of a Pri metastasize or infiltrate, and that various polyclonal cancer cells proliferate to different degrees under different circumstances.
Keywords: DNA ploidy pattern, Heterogeneity, Gallbladder carcinoma, Stemline
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REFERENCES
- 1. ) Coons , S. W. and Johnson , P. C.Regional heterogeneity in the DNA content of human gliomas . Cancer , 72 , 3052 – 3060 ( 1993. ). [DOI] [PubMed] [Google Scholar]
- 2. ) Bonsing , B. A. , Beerman , H. , Kuipers , D. N. , Fleuren , G. J. and Cornelisse , C. J.High levels of DNA index heterogeneity in advanced breast carcinomas. Evidence for DNA ploidy differences between lymphatic and hematogenous metastases . Cancer , 71 , 382 – 391 ( 1993. ). [DOI] [PubMed] [Google Scholar]
- 3. ) Symmans , W. F. , Liu , J. , Knowles , D. M. and Inghirami , G.Breast cancer heterogeneity: evaluation of clonality in primary and metastatic lesions . Hum. Pathol. , 26 , 210 – 216 ( 1995. ). [DOI] [PubMed] [Google Scholar]
- 4. ) Japanese Society of Biliary Surgery . In “ General Rules for Surgical and Pathological Studies on Cancer of Biliary Tract ,” 3rd ed. pp. 29 – 59 ( 1993. ). Kanehara Co. , Tokyo . [Google Scholar]
- 5. ) Hedley , D. W. , Friedlander , M. L. , Taylor , I. W. , Rugg , C. A. and Musgrove , E. A.Method for analysis of cellular DNA content of paraffin‐embedded pathological material using flow cytometry . J. Histochem. Cytochem. , 31 , 1333 – 1335 ( 1983. ). [DOI] [PubMed] [Google Scholar]
- 6. ) Baretton , G. , Blasenbreu , S. , Vogt , T. , Lohrs , U. , Rau , H. and Schmidt , M.DNA ploidy in carcinoma of the gallbladder. Prognostic significance and comparison of flow and image cytometry on archival tumor material . Pathol. Res. Pract. , 190 , 584 – 592 ( 1994. ). [DOI] [PubMed] [Google Scholar]
- 7. ) Haber , M. M. , Liu , J. , Knowles , D. M. and Inghirami , G.Determination of the DNA content of the Reed‐Sternberg cell of Hodgkin's disease by image analysis . Blood , 80 , 2851 – 2857 ( 1992. ). [PubMed] [Google Scholar]
- 8. ) Ando , H. , Sawada , T. , Saito , Y. , Sunouchi , K. , Masaki , T. , Suzuki , K. , Hamaguchi , M. , Sameshima , S. , Shinozaki , M. and Tsuno , N.Feasibility of DNA analysis for prognostic evaluations of colorectal cancer using touch preparations and image cytometry . Cancer Chemother. , 1 , 89 – 94 ( 1994. ) ( in Japanese ). [PubMed] [Google Scholar]
- 9. ) Kaern , J. , Wetteland , J. , Trope , C. G. , Farrants , G. W. , Juhng , S. W. , Pettersen , E. O. , Reith , A. and Danielsen , H. E.Comparison between flow cytometry and image cytometry in ploidy distribution assessments in gynecologic cancer . Cytometry , 13 , 314 – 321 ( 1992. ). [DOI] [PubMed] [Google Scholar]
- 10. ) Lanigan , D. , McLean , P. A. , Curran , B. and Leader , M.Comparison of flow and static image cytometry in the determination of ploidy . J. Clin. Pathol. , 46 , 135 – 139 ( 1993. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11. ) Masaki , T. , Muto , T. and Suzuki , K.Adenoma of the colon and DNA . Stomach Intestine , 24 , 308 – 316 ( 1989. ) ( in Japanese ). [Google Scholar]
- 12. ) Jin , Z. , Kuroda , A. , Wada , Y. , Muto , T.DNA content in the heterogenesis of carcinomas of the pancreas and papilla of Vatef by cytophotometric analysis . J. Biliary Duct Pancreas , 13 , 283 – 290 ( 1992. ) ( in Japanese ). [Google Scholar]
- 13. ) Sato , Y. , Tanaka , J. , Koyama , K. , van Guilk , T. M. , Lygidakis , N. J. and van der Heyde , M. N.Tumor DNA content in gallbladder carcinoma . Hepatogastroenterology , 40 , 375 – 379 ( 1993. ). [PubMed] [Google Scholar]
- 14. ) Allison , D. C. , Bose , K. K. , Hruban , R. H. , Piantadosi , S. , Dooley , W. C. , Boitnott , J. K. and Cameron , J. L.Pancreatic cancer cell DNA content correlates with long‐term survival after pancreatoduodenectomy . Ann. Surg. , 214 , 648 – 656 ( 1991. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15. ) Eskelinen , M. , Lipponen , P. , Collan , Y. , Marin , S. , Alhava , E. and Nordling , S.Relationship between DNA ploidy and survival in patients with exocrine pancreatic cancer . Pancreas , 6 , 90 – 95 ( 1991. ). [DOI] [PubMed] [Google Scholar]
- 16. ) Eskelinen , M. , Lipponen , P. , Marin , S. , Haapasalo , H. , Makinen , K. , Puittinen , J. , Alhava , E. and Nordling , S.DNA ploidy, S‐phase fraction, and G2 fraction as prognostic determinants in human pancreatic cancer . Scand. J. Gastroenterol , 27 , 39 – 43 ( 1992. ). [DOI] [PubMed] [Google Scholar]
- 17. ) Yoshimura , T. , Manabe , T. , Imamura , T. , Imanishi , K. , Ohshio , G. , Yamabe , H. , Kitamura , O. , Matsumoto , M. , Ogasahara , K. and Takasan , H.Flow cytometric analysis of nuclear DNA content of duct cell carcinoma of the pancreas . Cancer , 70 , 1069 – 1074 ( 1992. ). [DOI] [PubMed] [Google Scholar]
- 18. ) Futakawa , N. , Kimura , W. , Yamagata , S. , Ando , H. , Muto , T. and Esaki , Y.Heterogeneity of nuclear DNA ploidy and K‐ras point mutation in primary and metastatic lesions of carcinoma of the gallbladder . Proc. Jpn. Cancer Assoc. 53rd Annu. Meet , 272 ( 1994. ). [Google Scholar]