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Flow Cytometric Determination of DNA Content in Renal Cell Carcinoma with Special Reference to Tumor Heterogeneity : 신세포암에서 종양의 이질성을 고려한 DNA Flow Cytometry 분석

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Lee, Sang Eun; Choo, Myung Soo; Kim, Hyeong Gon; Kim, Tae Jin; Kim, Chul Woo; Lee, Jong Bouk

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Seoul National University College of Medicine
Seoul J Med, Vol.32 No.3, pp. 161-169
Flow cytometryTumor heterogeneityRenal cell carcinoma
The DNA (deoxyribonucleic acid) content in 111 samples from 14 renal
cell carcinomas (8 samples per one tumor specimen) was analyzed by flow cytometry
to investigate DNA heterogeneity in renal cell carcinomas and DNA ploidy patterns
were also compared with histologic grade and tumor stage. Of the 50 grade I and
22 grade II tumor samples, 46 (92%) and 14 (64%) were diploid respectively, but only
5 (13%) of 39 grade III & IV samples were diploid. This was statistically significant
(p=O.OI). Of the 9 pT2NoNo tumors, diploid were 4 (44%) and of 5 pT3NanyMo tumors
(4 T3aNoMo, 1 T3bN1Mo), diploid was 1 (20%). No statistical correlation was made between
tumor stage and ploidy status, because of the small number of specimens. Tumor heterogeneity
was noted in 8 of 14 tumors (57%). Of the 6 homogeneous tumors, five were
diploid and one was aneuploid. Of the 9 aneuploid tumors (64%), only one (7%) was
homogeneously aneuploid and 8 (57%) were heterogeneously aneuploid. The probability
of having an aneuploid sample by taking at random 1, 2, 3, 4 samples from a tumor
specimen was 65%, 88%, 94% and 97%, respectively. In conclusion, renal cell carcinoma
is heterogenous in terms of DNA ploidy. For flow cytometric evaluation at least 4 samples
need to be analyzed to minimize the sampling error and obtain aneuploidy with
95% confidence in one tumor specimen.
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