Comparison of histologic and cytologic specimens of urothelial carcinoma with image analysis. Implications for grading.
OBJECTIVE
To compare DNA results obtained by each of three preparation types (cytologic smears or cytocentrifuge samples, tissue sections and nuclei extracted from paraffin-embedded tissue) on patients with primary urothelial cell carcinoma of the bladder.


METHODS
Cases were selected for study based on the histologic diagnosis and the availability of corresponding bladder washing cytologic specimens. Five-micrometer sections and nuclear extracts were prepared from biopsies. DNA analysis was accomplished by use of an image cytometer on the Feulgen-stained material.


RESULTS
DNA content results correlated with both histologic and cytologic grade. Using a binary classification system, bladder washings and thin tissue section results concurred in 40/43 patients. Nuclear extracts were performed on 27 of the biopsies. The DNA content determined by nuclear extract agreed with the tissue section results for all 27 biopsies.


CONCLUSIONS
All three specimen preparations yield comparable DNA content results using a binary DNA classification scheme (diploid or aneuploid). Histologic grading can be enhanced with DNA content results, particularly in the heterogeneous, grade 2 group of urothelial carcinomas.
Forte
J D
JD
Department of Pathology and Laboratory Medicine, Veterans Affairs Medical Center, Gainesville, Florida, USA.
Croker
B P
BP
Hendricks
J B
JB
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000145:classification / Q000473:pathology*; D002467:Cell Nucleus / Q000473:pathology*; D003581:Cytodiagnosis / Q000379:methods; D004273:DNA, Neoplasm / Q000032:analysis*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016612:Paraffin Embedding; D015203:Reproducibility of Results; D001749:Urinary Bladder Neoplasms / Q000145:classification / Q000473:pathology*
D004273:DNA, Neoplasm