Prospective flow cytometric DNA analysis of hepatocellular carcinoma specimens collected by ultrasound‐guided fine needle aspiration

Background. The survival of 52 patients with hepatocellular carcinoma (HCC) seen during the last 4 years was analyzed prospectively on the basis of disease stage and nuclear DNA content. Methods. Ploidy was measured by flow cytometry (FCM). Cells for cytologic diagnosis and FCM were collected by ultrasound‐guided fine needle aspiration. Results. DNA aneuploidy, which was detected in 62% of the patients, did not correlate with clinicopathologic features, except in the sonographic aspect (P = 0.03). However, ploidy correlated significantly with survival; the survival times for patients with an aneuploid DNA index were significantly shorter than for those with a diploid index (P = 0.02). In a Cox multivariate analysis, DNA content was prognostically significant, as were the grade of cirrhosis severity and the echographic aspect. Conclusions. In addition to the clinicopathologic features observed, FCM DNA analysis of ultrasound‐guided fine needle aspirates from HCC is a simple and valid method for estimating a prognosis of these patients Cancer 1994; 74:599‐605.