Clinical Feature and Pathogenesis of Multiple Synchronous Carcinoma in the Colon and Rectum in Terms of Nuclear DNA Content

Hiroshi Ishikawa, Toru Nakagoe, Teruhisa Shimizu, Tatsuo Hirano, Hiroyuki Kusano, Keiji Kajiwara, Hiroyuki Yamaguchi, Takayuki Nakasaki, Naoki Kawazoe, Souei Lin, Toshio Miura, Masao Tomita

First Department of Surgery, Nagasaki University School of Medicine

A clinicopathological study and flow cytometric measurements on DNA ploidy pattern were carried out in 34 cases with multiple synchronous carcinomas of colon and rectum. In 44% of the patient, the carcinomas were situated in a single segment (especially sigmoid colon). The incidence of early carcinoma (m, sm) and well differentiated adenocarcinoma was high in 2nd cancer compared to 1st cancer. The 5-year survival rate was improved in patient with multiple carcinomas (75%) compared with single carcinomas (68%). As for DNA pattern, 27 carcinomas were DNA diploidy, and the other 10 were DNA aneuploidy in 37 carcinomas from 14 patients. There was no relationship between DNA ploidy pattern and gross type, histologic type, depth of invasion. In 7 of the 14 cases, all tumors within each colon and rectum were diploidy, in 4 cases the tumors differed with respect to DNA ploidy; and in 3 cases all tumors were aneuploidy, but DI from the tumors were different each other. These findings suggest that multiple synchronous carcinoma of colon and rectum may arise as multiple origin.

Key words
colorectal cancer, multiple synchronous carcinoma, flow cytometry

Reprint requests
Hiroshi Ishikawa First Department of Surgery, Nagasaki University School of Medicine
7-1 Sakamoto-cho, Nagasaki, 852 JAPAN

Accepted
April 17, 1991

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