Abstract
Background. The incidence and significance of tumor heterogeneity in primary tumors and metastatic lymph nodes were investigated in Stage IB-IIA cervical cancers. Methods. Paraffin-embedded tissues from 96 radical hysterectomy specimens were dewaxed, disaggregated, and subjected to dual parameter flow cytometry. Three-dimensional histograms were generated to delineate different tumor populations. A DNA index difference of at least ± 0.15 was used to define tumor heterogeneity. Results. Mean DNA index difference of various tumor populations was 0.29 ± 0.13. Among 69 patients with normal lymph nodes, there were 12 patients (incidence, 17.4%) with tumor heterogeneity in the primary tumors. Of 27 patients with metastatic lymph nodes, 5 (incidence, 18.5%) had evidence of tumor heterogeneity in the primary tumor, and 18 of 47 (incidence, 38.3%) had tumor heterogeneity in metastatic lymph nodes. When using DNA index to determine clonal origin of metastatic lymph nodes, as many as 60% of the metastases could not be traced to the primary tumor. Tumor heterogeneity was associated with a 40% reduction in median survival time. However, because of the small number of patients with tumor heterogeneity, statistical analyses did not show prognostic significance. Conclusions. Tumor heterogeneity appeared to be a common characteristic of early cervical carcinoma. Additional study is needed to fully evaluate its prognostic value.
Original language | English (US) |
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Pages (from-to) | 2543-2550 |
Number of pages | 8 |
Journal | Cancer |
Volume | 71 |
Issue number | 8 |
DOIs | |
State | Published - Apr 15 1993 |
Keywords
- cervical carcinoma
- lymph node
- metastasis
- survival
- tumor heterogeneity
ASJC Scopus subject areas
- Cancer Research
- Oncology