DNA Flow Cytometry in the Characterization of Transitional Cell Carcinoma of the Bladder. A Relation with Tumor Stage, Histopathologic Grade, Recurrence and Survival

Lee, Sang Eun

Abstract

DNA flow cytometry was performed on 93 deparaffinized surgical specimens to investigate the relationship with tumor stage and histopathologic grade as well documented predictors of clinical recurrence and survival. Aneuploidy, histopathologic grade and tumor stage were nondependent variables, and all correlated to statistical significance with disease recurrence. The incidence of aneuploidy in the total specimens was 55 of 93(59% ). The incidence of recurrence rate in patients with diploid tumor was 3/38 (7.9%) compared to 37/55 (67%) in patients with aneuploid tumor (p = 0.0000). The incidence of recurrence in patients with localized muscle invasion (T2, T3a) exhibiting concomitant diploidy was 4.3% compared to 43.6% in patients with localized muscle invasion and aneuploidy(p=0.0057). The incidence of recurrence in patients with grade II (intermediate grade) exhibiting concomitant diploidy was 4.3% compared to 53.3% in those with grade II and aneuploidy(p = 0.0057). The 5 years actuarial survival rate was 97% in patients with dip101d tumors compared to 38% in patients with aneuploid tumors. The 5 years actuarial survival rate was 95% in patients with localized muscle invasion(T2, T3a) exhibiting concomitant diploidy compared to 39% in those with aneuploid T2, T3a. The mean survival time was 91.4 months in patients with grade II exhibiting concomitant diploidy compared to 41.7 months in those with grade II exhibiting concomitant aneuploidy. In conclusion, the identification of DNA aneuploid stemline in transitional cell carcinoma of the bladder is correlated statistically with a higher T stage as well as histopathologic grade. The markedly increased probability of survival in patients with diploid tumor, even in localized muscle invasive group as well as intermediate histopathologic grade group suggests that DNA flow cytometry in transitional cell carcinoma of the bladder would significantly enhance prognostic stratification.