[Analysis of the malignant potentiality in superficial esophageal carcinoma by cytofluorometry of nuclear DNA and cellular protein contents--in relation to histopathologic findings and prognosis].

Recently patients with superficial esophageal carcinoma have increased due to progress in endoscopy, but the results of surgical treatment are still not satisfactory. Cytofluorometric analysis of nuclear DNA and cellular protein contents, measurements of malignant potentiality, in superficial esophageal carcinoma were performed, and DNA ploidy patterns were compared statistically with histological findings and prognosis. Nuclear DNA and cellular protein contents were measured by the multiparametric cytofluorometry in 72 patients with squamous cell carcinoma (mucosal ca.: 14 cases, submucosal ca.: 58 cases). DNA ploidy patterns were classified into diploid (without polyploid), polyploid, and aneuploid according to the peaks of the DNA content histogram. In the current study, there were 22 cases (30%) of diploid, 17 cases (24%) of polyploid, and 33 cases (46%) of aneuploid. In patients with polyploid and aneuploid, there was high frequency of lymph vessel invasion, as compared with diploid (p less than 0.01). The overall five-year survival rates of patients with diploid, polyploid, aneuploid were 91%, 71%, 55%. The prognosis in patients with aneuploid was poorer than diploid (p less than 0.05). The recurrent cases of early esophageal carcinoma were aneuploid only. DNA ploidy patterns proved to be one of the major prognostic factors by multivariate analysis. The patients with higher DNA content had a high frequency of lymph node metastasis. In the patients with poor prognosis, cellular protein content showed higher. These results suggest that the analysis of nuclear DNA and cellular protein contents are useful for assessing the prognosis and planning postoperative combined therapy in patients with superficial esophageal carcinoma.