Flow Cytometry for Followup Examinations of Conservatively Treated Low Stage Bladder Tumors

Abstract

A series of 26 conservatively treated patients with low stage bladder tumors was examined later by outpatient cystoscopy, conventional cytology and flow cytometry. Based on those findings the patients were separated into 5 groups. In the 4 patients in group 1 all findings persistently were negative. The 4 patients in group 2 had initially normal cystoscopy with progressively more abnormal flow cytometry and intermittently positive cytology; they subsequently suffered tumors. The 10 patients in group 3 had positive cystoscopy and flow cytometry, and intermittently positive cytology. The 6 patients in group 4 had negative cystoscopy with intermittently positive cytology and persistently positive flow cytometry. In all 6 cases flow cytometry was more sensitive than conventional cytology in detecting early and, sometimes, cystoscopically occult neoplasms. In the 2 patients in group 5 cystoscopically visible papillomas and low grade papillary carcinomas were found with negative flow cytometry and negative or suspicious cytology. The papillary tumors in these 2 patients were believed to be composed principally of benign or atypical epithelium, with too few malignant cells to be detected by present flow cytometry techniques. Our preliminary results suggest that flow cytometry may be a valuable tool for followup of patients who have had conservatively treated low stage bladder tumors and are at risk for development of carcinoma. In addition, the techniques may be used to monitor changes in the proportion of benign and malignant cells and, thus, can be of help in following the course of newly forming papillomas, papillary carcinomas or carcinoma in situ in papillomas or flat epithelium.

Tissue‐specific markers in flow cytometry of urological cancers. III. Comparing chromosomal and flow cytometric dna analysis of bladder tumors

“…DNA values obtained through FCM and proliferative data are useful tools for diagnosis, management and prognosis of patients with bladder tumors (Devonec et al, 1981;Gustafson et al, 1982;Klein et al, 1982;Chin et al, 1985). Normal modal chromosome number and DNA index obtained by FCM are in good agreement with each other in TCC.…”

“…DNA flow cytometric (FCM) analysis of carcinoma cells has been described as a useful and reproducible method in diagnosis and management of patients with bladder tumors (Devonec et al, 1981;Wijkstrom et al, 1984). In order to analyse the carcinoma cells separately from contaminating non-epithelial cells, antibodies to cytokeratin can be used in a 2-parameter analysis (Ramaekers et al, 1983(Ramaekers et al, , 1984Feitz et al, 1985Feitz et al, , 1986.…”

Prognostic factors in renal cell and bladder cancer

“…An increase in nuclear DNA content is regarded as a sign of genetic instability associated with potential malignant behaviour. DNA ploidy in cells obtained from bladder washings was correlated with progression to invasion and metastasis, and poor prognosis in flow cytometric studies [ 46, 47]. However, it is questionable whether ploidy provides additional information to tumour grade and stage [ 11, 48].…”

Grading in Superficial Bladder Cancer. (1) Morphological Criteria

“…Once diagnosed, the progression and recurrence rate of these superficial tumours are found to be associated with different histopathological parameters, such as depth of invasion, grade, papillary or non-papillary growth (Koss, 1975;Kern, 1984), number and size of visible tumours (Lutzeyer et al, 1982;Heney er al., 1983) and the presence of moderate to severe dysplasia in non-tumour bearing areas of the bladder (Althausen et al, 1976;Cutler et al, 1982). For prediction of the prognosis newer approaches such as deletion of blood group isoantigens (Summers et al, 1983), cytogenetic studies (Sandberg, 1977;Summers et al, 1983), DNA and RNA histograms (Devonec et al, 1981) and morphometric studies (Ooms et al, 1983) are available. Nevertheless, cytohistological grade is often the most important single item of prognostic value.…”