DNA ploidy analysis of mucinous cystic tumors of the pancreas. Correlation of aneuploidy with malignancy and poor prognosis.

Abstract

Benign and malignant pancreatic mucinous tumors differ in proliferative activity, production of tumor markers, and expression of growth factors. DNA ploidy is a useful index of aggressiveness and poor survival in ductal adenocarcinoma, but has not been studied in pancreatic cystic tumors. The DNA ploidy status of Fuelgen-stained tissue sections of pancreatic mucinous cystic tumors was evaluated by image cytometry and related to clinical outcome obtained by case record review. Ploidy status correlated with malignancy and poor clinical outcome. All benign mucinous cystadenomas (n = 13) were diploid and cured by resection. Patients with diploid cystadenocarcinomas (n = 6) had an 83% survival rate following resection, while patients with aneuploid cystadenocarcinomas (n = 5) all died (four of disease and the fifth of another cause). The difference in survival between the diploid and aneuploid carcinomas was significant (P = 0.04). DNA ploidy status of pancreatic mucinous tumors by image analysis provides quantifiable information that may be predictive of clinical outcome. DNA aneuploidy appears to be a significant differential factor in pancreatic mucinous tumors and is associated with shortened survival in mucinous cystadenocarcinomas.