Histological grading, DNA content, cell proliferation and survival of patients with astroglial tumors

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Abstract
Light microscopy, image cytometry (ICM), and flow cytometry (FCM) were used to study the degree of differentiation, DNA content, and S‐phase of astrocytomas and glioblastoma multiforme in 102 patients. The postoperative real survival time (RST) was also studied. Using ICM, 62 astrocytomas were investigated. Grade I astrocytomas were composed of DNA‐diploid cell lines, while grade III and glioblastoma multiforme consisted predominantly of DNA‐aneuploid lines. Moderately differentiated astrocytomas were divided as follows: 14 DNA‐diploid and 18 DNA‐aneuploid. Forty astrocytomas were studied by FCM. Using the DNA index (DI) value, cases with abnormal DNA cell lines were established in all astrocytomas, with their number increasing in grades II and III astrocytomas. FCM indicated the same subdivision of moderately differentiated astrocytomas: 12 with DNA‐diploid and 12 with DNA‐aneuploid stem lines. Patients with DNA‐diploid cell lines in the astrocytomas and low S‐fraction survived longer than patients with abnormal DNA cell populations and higher S‐fraction. The results from this study indicate that, together with the degree of differentiation of astroglial tumors, the appearance of cell lines with abnormal DNA value and higher S‐fractions also have prognostic value.