Clinical significance of abnormal nuclear DNA content in serous ovarian tumors

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Abstract
The nuclear DNA content of 160 serous ovarian neoplasms was determined by flow cytometry from paraffin-embedded tissue. Three (11%) of the 27 histologically benign, seven (16%) of the 43 borderline malignant, and 59 (66%) of the 90 malignant neoplasms were aneuploid (P < 0.0001). None of the patients with an aneuploid benign or borderline malignant tumor died from cancer, but in carcinomas the DNA index (DI) was a more important prognostic factor in a multivariate analysis than age at diagnosis, stage, histologic grade or ploidy (diploid versus aneuploid). A DI of 1.3 was the most effective value hi predicting prognosis; patients with carcinoma with the DI more than 1.3 had inferior survival compared with those with the DI less than 1.3 (P = 0.002). Carcinomas with the DI more than 13 were more common in patients older than 60 years at diagnosis (P = 0.0002), and were associated with a low grade of differentiation (P = 0.008) but not with stage. It is concluded that DNA aneuploidy may occur in benign and borderline malignant serous ovarian tumors and that the DI is a highly valuable and objective prognostic parameter in serous ovarian carcinomas.