DNA flow cytometry as a predictor of outcome of stage I renal cell carcinoma

Abstract

The features most frequently used in predicting the outcome of renal cell carcinoma are stage at presentation and nuclear grade. Recently DNA ploidy pattern, as detected by DNA flow cytometry has also been shown to be predictive. In this study DNA flow cytometry was performed on formalin-fixed paraffin-embedded tissue from 50 patients with Stage I renal cell carcinoma for whom long-term follow-up data were available. Two were eliminated for technical reasons. Of the 48 evaluable tumors, 25 (52%) were diploid, 19 (40%) were nondiploid, and in four, (8%) the ploidy was uncertain. The ploidy pattern was statistically significantly associated with nuclear grade (P < 0.02), and primary tumor size (P < 0.05) but did not correlate with cell type, microscopic growth pattern, or the presence or absence of mitotic activity. In the group as a whole, ten patients (21%) died of renal cell carcinoma, seven of 19 (37%) with nondiploid tumor patterns, and two of 25 (8%) with a diploid pattern (P < 0.03). One of four patients (25%) with tumors of uncertain ploidy also died. However, only two factors, nuclear grade and primary tumor size, were independent predictors of outcome. For Stage I renal cell carcinoma, ploidy can significantly predict patient outcome and correlates with nuclear grade and tumor size, but is not an independent predictive variable.

Appraisal of intratumoral microvessel density, MIB-1 score, DNA content, and p53 protein expression as prognostic indicators in patients with locally confined renal cell carcinoma

“…10, 30 The differences in survival with tumor size using older those of Rainwater et al, who also found that DNA ploidy did not correlate with survival in clear cell staging systems now are accounted for in the revised TNM system, in which tumors confined to the kidney RCC confined to the kidney. 37 Similarly, in more recent studies of localized RCC, DNA ploidy did not measuring°7 cm in greatest dimension correspond to a classification of pT1 and tumors measuring ú 7 predict survival.…”

Renal cell carcinoma. A clinicopathologic and dna flow cytometric analysis of 103 cases

“…Cox pro-portional hazards regression analysis showed DNA ploidy to be an independent predictor of adverse outcome; in a previous study restricted to Stage I renal cell carcinomas and so analyzed, we found DNA ploidy to be significant but not independent of tumor size and nuclear grade. 38 Our finding that the mean time to death from renal cell carcinoma was approximately twice as long in the diploid cases than in the nondiploid ones (62.3 months versus 34.1 months) is in keeping with the results of Ljungberg et Several systems for grading renal cell carcinoma have been devised, 1 9 , 2 3 3 2 4 3 3 6 and most have correlated with tumor behavior. ' 9,23,24,27-29,31,34,35 In this study we used the nuclear grading system proposed by Fuhrman et ~1 .…”

Classification strategies for the grading of renal cell carcinomas, based on nuclear morphometry and densitometry

“…[15][16][17][18][19] DNA ploidy level can also be determined by means of the computer-assisted microscopy of Feulgen-stained nuclei. 20,21 The aim of the present work was to determine, on a series of 65 RCCs, what type(s) of quantitative variables provided by computer-assisted microscopic analysis of Feulgen-stained nuclei contribute(s) diagnostic information and could therefore increase the accuracy of nuclear grading.…”