The prognosis is poor for advanced (stage III-IV) carcinomas of the tongue. The appearance of metastatic lymph nodes drastically reduces the 2-years survival rate because, in approximately 30% of the cases, metastatic lymph nodes are already present at the time of diagnosis, even in T1, but go undetected. The incidence of lymph nodes metastases has also been related to histological grading. However, this has not proved to be a reliable prognostic parameter, most likely because of the subjectivity of histopathological interpretation. Analysis of the DNA content, in association with other histopathological parameters, has proved to be a useful prognostic marker for other forms of tumors. This could also be the case for carcinomas of the tongue. The present study involved 26 patients who came under observation at the Otorhinolaryngology Clinic of the University of Catania between January 1990 and February 1995. All patients were subject to biopsy sampling and subsequent treatment. According to the UICC classification, then slides were prepared and stained according to Feulgen. A computerized image analysis system (Image-ProPlus) was used to determine the quantity of tumoral nuclear DNA. Analysis of the nuclear DNA content showed that 7 of the 26 carcinomas of the tongue (26.9%) were diploid, 19 (73.1%) aneuploid and of these 7 were also polypoid. In the aneuploid carcinomas the average DI was 1.50 with a range running from 0.70 to 3.1. The correlation of 3-year survival and the clinically studied DNA content showed that 6 of the 11 stage I-II patients were disease-free and had an average tumoral DNA index of 0.95. On the other hand, those cases which showed progression or local recurrences had an average tumoral DI of 1.25. In the group of stage III-IV patients 5 were disease free and showed an average tumoral DNA index of 1.03 while those showing recurrence or progression of the disease had an index of 1.94. The above results appear to confirm that the risk of progression or recurrence is strictly linked to an increase in the average DNA value.
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