Prognostic Value of Rate of Cells exceeding 4c DNA content in Oral Squamous : Cell Carcinoma with Special Reference to Mode of Cancer Invasion

This study was performed to elucidate the clinical significance of the nuclear DNA content of cancer cells in each mode of cancer invasion of oral squamous cell carcinoma. Cytophotometric DNA content was analyzed in tissue sections from biopsied specimens of 107 patients with squamous cell carcinoma. Contents of cells from the edge portion were analyzed in terms of rate of occurrence of cells with content exceeding 4c （Exceeding rate of 4c: 4cER）. The cells having DNA content exceeding 4c are regarded as polyploid and/or aneuploid cells. According to our analysis, the relationships of 4cER with clinical findings, histopathological findings, and prognosis were as follows: 1. Clinically advanced cancers, such as T4 and/or stage IV, or cancers with endophytic growth type tend to have high 4cER compared to cancers of small size and early stage （p<0.01）. 2. Cancers with histologically high malignancy, such as poorly differentiated, high degree of cellular atypism （C. A. T. III）, marked mitosis, and diffuse invasion tend to have high 4cER （p<0.01）. 3. 4cER correlated with tumor size based on each mode of cancer invasion, except mode 4C. 4. Patients with 4cER less than 10% had better prognoses than those with over than 10% （92.5% vs. 57.3%, p<0.01）. 5. Patients of mode-1, 2, who showed low 4cER and low malignancy, had an excellent 5-year cumulative survival rate （100% in mode-1, 2 respectively）. Among patients of mode-3, the 5-year cumulative survival rate of patients with 4cER less then 10% was significantly higher than those with over than 10% （90.0% vs. 51.0% p