The prognosis of the glandular neoplasms of the uterine cervix is related to the clinical stage and, to a lesser ewtent, to the histologic type, growth pattern, and degree of differentiation of the neoplasms. To determine further the prognostic significance of the stem cell ploidy levels as determined by nuclear DNA quantitation, the authors separated the tumors into low ploidy (less than 3N) and high ploidy (greater than 3N) groups. Of the clinical Stage I and I1 neoplasms, low ploidy tumors had a better prognosis than high ploidy tumors of comparable stage. Low ploidy tumors had a better prognosis than high ploidy tumors irrespective of the degree of differentiation. Mixed carcinomas had a poorer prognosis than pure adenocarcinomas of comparable clinical stage. This might be explained by the greater proportion of high ploidy stem cells in mixed carcinomas than in pure adenocarcinomas. Although advanced clinical Stage 111 and IV neoplasms had a poor outlook regardless of the DNA ploidy level, there was a proportional increase of high ploidy tumors with increasing clinical stage. These findings suggest that cervical glandular neoplasms having high ploidy stem cell lines are biologically more aggressive than those with low ploidy stem cell lines.
Cancer 492571-2577, 1982.
N A PREVIOUS cliriicopathologic study of glandular I neoplasms of the uterine cervix, the clinical stage, histologic type, and degree of differentiation were found to be related to the prognosis.' Pure adenocarcinomas had a better prognosis than mixed carcinomas of comparable clinical stage."* Of the pure adenocarcinomas, the endometrial type and endocervical type having papillary and glandular patterns had a better prognosis than the mucinous ~a r i a n t . ' . ~ The differentiation provides a reasonably aiccurate prediction of the outlook for patients with pure adenocarcinoma~.'*~~~ The prog- nosis for mixed carcinomas was poor regardless of the differentiation.'' These findings suggest that other factors may influence tlhe biologic behavior of these neoplasms. Previous nuclear DNA studies of uterine cancers have shown that the stem cell modal values, as determined by the technique of Feulgen microspectrophotometry, correlate better with prognosis than with