DNA ploidy and biologic aggressiveness of gastric adenocarcinoma in Chinese

The mortality rate of gastric cancer in the Chinese population has reached a plateau. The main prognostic factor for gastric adenocarcinoma is recognized as tumor stage. Recently, abnormalities in DNA content have been considered as a new prognostic factor. Whether abnormal DNA content can be used as a prognostic tool for Chinese patients with gastric cancer is unknown. To investigate this relation DNA ploidy and prognosis of gastric cancer patients were studied using paraffin-embedded specimens. A group of 104 newly diagnosed and surgically resected gastric cancer specimens obtained from January 1984 to December 1986 were examined for DNA content by flow cytometry. The quality of flow cytometry was acceptable with a mean coefficient of variance of 5.45. The results showed that 38 cases (36.5%) had DNA aneuploidy; 42 cases had metastatic lymph nodes with enough tumor cells, and 31.0% of these cases had DNA aneuploidy. DNA aneuploidy of primary tumors was correlated to lymph node metastasis and patient's age, whereas DNA aneuploidy of metastatic lymph nodes was significantly correlated to the serosal invasion of the gastric wall at the primary site. The important parameters for prognosis were curability of surgical resection, serosal invasion, tumor size, and distant metastasis. DNA aneuploidy of both primary tumors or metastatic lymph nodes appeared to be unrelated to the prognosis of gastric adenocarcinoma in Chinese patients. We therefore propose that DNA aneuploidy of gastric cancer is associated with tumor growth but not biologic aggressiveness.