A high ratio of apoptosis to proliferation correlates with improved survival after radiotherapy for cervical adenocarcinoma.
AffiliationCRC Section of Genome Damage and Repair, Paterson Institute for Cancer Research, Christie Hospital, Manchester, United Kingdom.
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AbstractPURPOSE: A retrospective study was made of the role of apoptosis in determining radiotherapy outcome in 39 adenocarcinoma of the cervix. A comparison was also made of the detection of apoptosis by morphology and the TdT dUtp nick end-labeling (TUNEL) assay. METHODS AND MATERIALS: The level of apoptosis was assessed in paraffin-embedded sections by cell morphology, the TUNEL assay, and a combination of the two. A total of 2,000 cells were counted per section, to obtain apoptotic (AI) and mitotic (MI) indices. RESULTS: Patients with a high AI had a higher survival rate than those with a low AI, however, the difference was not significant. Using a ratio of apoptosis to proliferation indices, patients with an AI:MI > median had significantly better survival than those with AI:MI < median. This was true where the AI was quantified by morphology alone (p = 0.030) or in combination with the TUNEL assay (p = 0.008). Where the AI was quantified by a combination of morphology and TUNEL, the 5-year survival rates for women with AI:MI greater or less than the median were 81% and 25%, respectively. CONCLUSION: A high ratio of AI:MI in adenocarcinoma of the cervix indicates a good prognosis. A combination of the TUNEL assay and morphology provided the best discrimination between outcome groups.
CitationA high ratio of apoptosis to proliferation correlates with improved survival after radiotherapy for cervical adenocarcinoma. 1999, 44 (3):507-12 Int. J. Radiat. Oncol. Biol. Phys.
JournalInternational Journal of Radiation Oncology, Biology, Physics