Prognostic significance of nuclear analysis in invasive carcinoma of cervix patients treated by primary radiation

The value of microspectrophotometric analysis was studied for the assessment of prognosis in patients with squamous cell carcinoma of the cervix treated with primary radiation therapy. Cellular nuclear desoxyribonucleic acid (DNA) content and nuclear size were measured in smears taken before, during and immediately after radiation therapy. Additional determination of DNA content/nuclear size ratio was made. Changing patterns of DNA distribution, nuclear size and their ratio were classified into Type I, II, III, and IV, according to the mode of their shifts in the course of radiation therapy. The results showed diploid (47 %), polyploid (23 %) and aneuploid (30 %) DNA distribution in pre-treated carcinomas. Particularly, the results showed a distinct correlation between the type of histograms and patient outcome. Patients with Type II histograms (initial shift to the right and posterior shift to the left) showed a better survival rate and no recurrences compared with other types. On the other hand, patients with Type III histograms (initial shift to the left and posterior shift to the right) had poor prognosis and were predominant among dead cases with radioresistant tumors. These results suggested the potential usefulness of cytophotometric analysis for assessing prognosis in advanced cases. (author)