Summary
Background
Precise preoperative assessment of diagnosis and prognosis in patients with pancreatic tumors would facilitate improvement of treatment strategies. In this context, we evaluated the significance of the proliferative index and of static DNA cytophotometry in the diagnosis and prognosis of pancreatic tumors.
Methods
Consecutive surgical specimens from 26 patients with ductal pancreatic cancers and eight patients with chronic pancreatitis were investigated by:
-
1.
Staging;
-
2.
Conventional histological and cytological grading;
-
3.
MIB-1 (Ki-67 labeling) proliferating index; and
-
4.
Static DNA cytophotometry.
Results
All patients with chronic pancreatitis had a normal MIB-1 labeling index and a euploid DNA content. In contrast, patients with pancreatic cancers rarely had a normal labeling index (1 of 26 patients) or a euploid DNA content (6 of 26 patients). Staging significantly correlated with survival time. However, it did not correlate with cytological criteria. Cytological criteria, such as conventional grading, MIB-1 proliferating index, and DNA ploidy, were not significantly correlated with survival time. Conventional grading was significantly correlated (p<0.02) with proliferating index, but not with DNA ploidy.
Conclusion
Proliferating index and DNA ploidy are relevant cytological markers that can help to discriminate between chronic pancreatitis and pancreatic cancer. The prognostic significance of these markers in pancreatic cancer patients, however, seems to be less relevant than tumor stage and of limited relevance for the individual cancer patient.
Similar content being viewed by others
References
Gudjosson B. Cancer of the pancreas. Fifty years of surgery.Cancer 1987; 60: 2284–2303.
Schmassmann A, Halter F. Diagnosis and staging in pancreatic cancer: endoscopic retrograde cholangiopancreatography and endoscopic ultrasound.Dig Surg 1994; 11: 346–350.
Manabe T, Suzuki T, Tobe T. Factors influencing prognosis and indications for curative pancreatectomy for ductal adenocarcinoma of the head of the pancreas.Int J Pancreatol 1990; 7: 187–193.
Rugge M, Sonego F, Sessa F, Leandro G, Capella C, Sperti C, et al. Nuclear DNA content and pathology in radically treated pancreatic carcinoma. The prognostic significance of DNA ploidy, histology and nuclear grade.Cancer 1996; 77:459–466.
Cattoretti G, Becker MH, Key G, Duchrow M, Schlüter C, Galle J, et al. Monoclonal antibodies against recombinant parts of the Ki67 antigen (MIB1 and MIB3) detect proliferating cells in microwave-processed formalin-fixed paraffin sections.J Pathol 1992; 168: 357–363.
Youssef EM, Matsuda T, Takada N, Osugi H, Higashino M, Kinoshita H, et al. Prognostic significance of the MIB-1 proliferation index for patients with squamous cell carcinoma of the esophagus.Cancer 1995; 76: 358–366.
Jochum W, Schroeder S, al-Taha R, August C, Gross AJ, Berger J, et al. Prognostic significance of nuclear DNA content and proliferative activity in renal cell carcinomas. A clinicopathologic study of 58 patients using mitotic count, MIB-1 staining, and DNA cytophotometry.Cancer 1996; 77: 514–521.
Aktin N, Kay R. Prognostic significance of modal D and other factors in malignant tumours, based on 1465.Cancer 1979; 40: 210–221.
Auer GU, Casperson TO, Wallgren AS. DNA content and survival in mammary carcinoma.Anal Quant Cytol 1980; 2: 161–165.
Weger AR, Falkmer UG, Schwab G, Glaser K, Kemmler G, Bodner E, et al. Nuclear DNA distribution pattern of the parenchymal cells in adenocarcinomas of the pancreas and in chronic pancreatitis. A study of archival specimens using both image and flow cytometry.Gastroenterology 1990; 99: 237–242.
Weger AR, Glaser KS, Schwab G, Oefner D, Bodner E, Auer GU, et al. Quantitative nuclear DNA content in fine needle aspirates of pancreatic cancer.Gut 1991; 32: 325–328.
Allison DC, Bose KK, Hruban RH, Piantadosi S, Dooley WC, Boitnott JK, et al. Pancreatic cancer cell DNA content correlates with long-term survival after pancreatectomy.Ann Surg 1991; 214: 648–656.
Böttger TC, Störkel S, Wellek S, Stöckle M, Junginger T. Factors influencing survival after resection of pancreatic cancer: A DNA analysis and a histomorphologic study.Cancer 1994; 73, 63–73.
Herrera MF, Heerden van JA, Katzmann JA, Weiland LH, Nagorney DM, Ilstrup D. Evaluation of DNA nuclear pattern as a prognostic determinant in resected pancreatic ductal adenocarcinoma.Ann Surg 1991; 215: 120–124.
Hyöty M, Visakorpi T, Kallioniemie OP, Mattila J, Kaippala P, Nordbock J. Prognostic value of analysis of DNA in pancreatic adenocarcinoma by flow cytometry.Eur J Surg 1991; 157: 595–600.
Lundin J, Nordling S, von Boguslawsky K, Roberts PJ, Haglund C. Prognostic value of Ki-67 expression, ploidy and S-phase fraction in patients with pancreatic cancer.Anticancer Res 1995; 15: 2659–2668.
Klöppel G, Solcia E, Longnecker DS, Capella C, Sobin LH, eds.Histological Typing of Tumors of the Exocrine pancreas. WHO. Springer, Berlin, 1996.
Sachs L, ed.Angewandte Statistik. Springer, Berlin, 1973.
Gerdes J, Schwab U, Lemke H, Stein H. Production of a mouse monoclonal antibody with a human nuclear antigen associated with cell proliferation.Int J Cancer 1983; 31: 13–20.
Lee CS. Differences in cell proliferation and prognostic significance of proliferating cell nuclear antigen and Ki-67 antigen immunoreactivity in in situ and invasive carcinomas of the extrahepatic biliary tract.Cancer 1996; 78: 1881–1887.
Johansson B, Bardi G, Heim S, Mandahl N, Mertens F, Bak-Jensen E, et al. Nonrandom chromosomal rearrangements in pancreatic carcinomas.Cancer 1992; 69: 1674–1681.
Johansson B, Bardi G, Pandis N, Gorunova L, Backman LP, Mandahl N, et al. Karyotypic pattern of pancreatic adenocarcinomas correlates with survival and tumor grade.Int J Cancer 1994; 58: 8–13.
Duijndam WA, van Duijn P. The influence of chromatin on the stoichiometry of the Feulgen-Schiff procedure studied on model films. II. Investigations on films containing condensed or swollen chicken erythrocyte nuclei.J Histochem Cytochem 1975; 23: 891–900.
Klapperstück T, Wohlrab W. DNA image cytometry on sections as compared with image cytometry on smears and flow cytometry in melanoma.Cytometry 1996; 25: 82–89.
Yoshimura T, Manabe T, Imamura T, Imanishi K, Ohshio G, Yamabe H, et al. Flow cytometry of nuclear DNA content of duct cell carcinoma of the pancreas.Cancer 1992; 70: 1069–1074.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Loertzer, H., Hinze, R., Knolle, J. et al. Significance of proliferative activity and DNA ploidy in pancreatic cancer and chronic pancreatitis. Int J Gastrointest Canc 26, 77–83 (1999). https://doi.org/10.1007/BF02781734
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02781734