Flow cytometry analysis of malignant tumors of the head and neck--differences between two methods in the recognition of aneuploidy

DNA aneuploidy, which reflects changes in nuclear DNA-content, as determined cytometrically is a candidate prognostic factor in squamous cell carcinoma of the head and neck. The aim of this study was to compare two different preparation methods with respect to their use in detecting aneuploid tumor cell populations in malignant tumors of the head and neck. Fresh frozen tumor material was used. The methods compared were a multistep procedure (A) including fixation of cells and enzymatic treatment, and a one step procedure (B). Both include RNAse and the use of propidium iodide for DNA staining. Forty-seven percent of the tumors were non-diploid according to method A, and 29% according to method B, discordant findings being made in 15 tumors, only two of which were non-SCC. Defining a 'true non-diploid tumor' in this series as a tumor with a DNA index outside the range of diploidy detected either by method A or B, 59% (29/49) of the tumors were non-diploid. The sensitivity was 0.48 (14/29) for method B and 0.79 (23/29) for method A. The striking differences in accuracy between methods A and B emphasize the need of caution when new methods are introduced, and when results obtained with different methods are compared.