Abstract

Flow cytometric DNA analysis was performed on 167 biopsies from 131 patients with transitional cell carcinoma of the bladder, all histologically confirmed. The degree of aneuploidy increased with tumour grade: G1 tumours were generally diploid (71%); G2, G3 tumours and carcinoma in situ were aneuploid (61%, 79% and 100%, respectively). There were 33 cases of newly diagnosed G2 tumours, all treated by transurethral resection; 11 tumours were diploid, whereas the aneuploid cases could be divided into two distinct populations on the basis of the DNA-index (DI): I) 1.0 1.5. In group I a significantly lower number of cases (9%) showed tumour recurrence within 1 year, compared to group II (77%) (P=0.001; Fisher's test). This could not be explained solely by differences in tumour stage. G2 tumours of a higher stage (at least P1b) showed more early recurrences compared to lower stage tumours (P=0.02). In cases of discrepancies, however, the degree of aneuploidy, was found highly predictive for early tumour recurrence. Flow cytometric analysis of DNA content offers additional information for the recognition of rapidly recurring G2 bladder tumours allowing early installation of appropriate therapy.

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