Quanticyt: karyometric analysis of bladder washing for patients with superficial bladder cancer.
OBJECTIVE
Quantitative cytology by image-analysis techniques enables objective interpretation of nuclear features in light microscopic images. QUANTICYT, a quantitative karyometric cytology system, was used in the follow-up of patients with superficial bladder cancer.


METHODS
From 1992 to 1995, 4137 samples from 1412 patients were obtained. At 1-year follow-up after the initial bladder washing, a tumor recurrence rate of 21% was found. In this period, tumor progression to invasive disease occurred in 1.6% of patients. Scoring of tumor by the QUANTICYT system was based on two nuclear features: the 2c deviation index and the mean of a nuclear shape feature: MPASS.


RESULTS
The method was found to be reproducible and superior to visual cytologic interpretation. QUANTICYT analysis of the bladder washings resulted in a score of low, intermediate, and high risk. In a multivariate analysis, highest grade of earlier tumor and QUANTICYT risk score were the best predictors of tumor recurrence and progression. For the easy application of QUANTICYT analysis in daily routine, a report form that included patient history and DNA histogram was developed.


CONCLUSIONS
QUANTICYT karyometric analysis of bladder-wash material proved a useful, clinically applicable grading tool in the follow-up of patients with superficial bladder cancer, with sufficient power to be used in decision-making in the individual patient.
van der Poel
H G
HG
Department of Urology, University Hospital, Nijmegen, The Netherlands.
Witjes
J A
JA
van Stratum
P
P
Boon
M E
ME
Debruyne
F M
FM
Schalken
J A
JA
D000283:Administration, Intravesical; D001500:BCG Vaccine / Q000008:administration & dosage; D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000628:therapy; D018450:Disease Progression; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007620:Karyometry / Q000295:instrumentation; D008297:Male; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000628:therapy
D001500:BCG Vaccine