Circadian and ultradian rhythms of proliferation in human ovarian cancer.

Synchronous waves of proliferation in tumor cells taken from patients with ovarian cancer were observed using flow cytometry to measure the fraction of cells undergoing DNA replication and displaying tumor-cell-specific immunofluorescence. When saline washings of the abdominal cavity were analyzed at 2-4 hr intervals round-the-clock, the percentage of cells in the chromosome replication cycle (S + G2 percentage) showed 12-hr and often higher frequency rhythms in proliferation. These higher frequency rhythms in DNA replication show a relatively constant phase relationship to the patient's circadian clock with peak proliferation occurring most commonly at 10 a.m. to 12 noon and again at 10 p.m. This proliferation rhythm is therefore partially out of phase with the 24-hr rhythms in proliferation seen in normal cells. The findings on human cancer reveal a fundamental difference in the temporal organization of normal and tumor cell growth that should be exploited for therapeutic benefit.