The clinical usefulness of DNA aneuploidy in borderline ovarian tumours.

ploidy with a DNA index of 1.9 was detected in only 1 patient. This patient, who had a stage IA serous BOT, is alive without any recurrence after 96 months of observation following TAH/BSO. All the remaining 69 tumours showed diploid DNA content. The coefficient of variation for the diploid peaks ranged from 7.48 to 12.8 (mean 8.67) in diploid histograms despite using a low flow rate. A recent review [3] stated that the primary treatment modality for the management of BOT is surgery. Based on the prognostic importance of DNA ploidy suggested by Kaern et al. [2], the same review recommends the analysis of DNA ploidy in their management algorithm. Whilst we recognise the prognostic importance of DNA ploidy, in our experience it unlikely to be a useful clinical discriminator due to a low prevalence rate; only 1 of our 70 patients (1,4%) had DNA aneuploidy. The aneuploidy rate was 9% in the study by Kaern et al. [2] which might be attributed to larger sample size, observer bias in identifying and grading BOT, differences in study population, histological type, tumour stage at presentation, study methodology and various biases inherent in retrospective studies. A multicentre prospective study with central pathology review is needed to confirm the prevalence and prognostic value of ploidy before ploidy is used routinely in treatment algorithms.