[DNA ploidy and cell cycle phase analysis with flow cytometry in bladder wash. Preliminary experience].
OBJECTIVE
To analyze the prognostic significance in bladder carcinoma of DNA ploidy and cell phase fractions measured by bladder wash flow cytometry.


METHODS
Samples were obtained from 25 patients by bladder irrigation; 16 before surgery and 9 during follow-up cystoscopic examination. Cells were stained with propidium iodide and analyzed with the FacScan flow cytometer and Cellfit 2.01 (Becton-Dickinson).


RESULTS
The number of cells obtained was sufficient for flow cytometric analysis in all cases. In 13 tumor samples (8 superficial and 5 invasive tumors), aneuploidy cells were detected in 3 cases that had a worse outcome; the only superficial tumor in which aneuploidy was detected presented a recurrent bladder carcinoma 15 months later. Of the 5 patients with invasive tumors, two patients with aneuploidy died within 6 months from tumor metastases. Of the patients without macroscopic tumor, only one showed an increase in the percentage of the S phase fraction (19.5% of cells in S phase). A recurrent bladder carcinoma was detected in this patient 6 months after the analysis. In patients with macroscopic tumor, analysis of the S phase fraction was not relevant for prognosis.


CONCLUSIONS
Analysis of DNA ploidy and cell phase fractions by flow cytometry of bladder washings can increase the prognostic information in bladder carcinoma. Aneuploidy was associated with a worse prognosis and an increase in the S phase fraction predicted a recurrent bladder carcinoma months before it manifested clinically.
Rivas del Fresno
M
M
Servicio de Urología, Hospital de Cabueñes, Gijón, Asturias, España.
Salas Bustamante
A
A
Suárez González
J A
JA
Tardón García
A
A
Sampedro Nuño
A
A
D004273:DNA, Neoplasm; D005434:Flow Cytometry; D006801:Humans; D011003:Ploidies; D011379:Prognosis; D016196:S Phase; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000235:genetics* / Q000473:pathology*
D004273:DNA, Neoplasm