The Significance of Ploidy and Proliferation in the Clinical and Biological Evaluation of Bladder Tumours: a Study of 100 Untreated Cases

Abstract

Cell material from 100 cases of newly diagnosed bladder tumours was studied with rapid flow cytofluorometric DNA analysis. The degree of ploidy and the percentage of cells in the S-phase characterising the proliferation pattern of the tumours were determined from DNA histograms. The results were related to the tumour categories and to the histopathological grading of the tumours. Approximately 40% of T1 tumours showed aneuploid DNA patterns, while in the other categories aneuploidy was found in almost all cases. With few exceptions, tumours of Grade 1 were found to be diploid and tumours of Grade 3 aneuploid. In tumours of Grade 2, two-thirds were found to be diploid and one-third aneuploid. In the group of aneuploid tumours the tetraploid cases exhibited the least malignant characteristics as judged by histological grades and tumour categories. The aneuploid non-tetraploid tumours increased in malignancy the more they deviated from tetraploidy. This might be explained by our observations of a positive correlation between the degree of ploidy and the degree of proliferation. The proliferation increased from 10% in tetraploid tumours to 20% in triploid and pentaploid tumours.

Proliferative characteristics of primary and metastatic human solid tumors by DNA flow cytometry

“…In agreement with other investigators (5,9,22), S-index was significantly lower in diploid than in aneuploid tumors. Cytological analysis showed that cell suspensions from most diploid tumors contained a significant proportion of normal cells.…”

“…This observation was made both when S-index was estimated by FCM (5,10,16) or H3-thymidine incorporation (4,12,23). For bladder carcinomas, the proportion of S-phase cells estimated by FCM increased directly with an increasing degree of invasion (22). Melanoma patients with a proportion of S-phase cells 210% had a significantly shorter survival time when compared to patients with < 10% S-phase cells (9).…”

Consensus review of the clinical utility of dna cytometry in bladder cancer

“…DNA ploidy status of irrigation and tumor specimens correlates with grade and stage (2, 7,8,16,35). The maximum utility of DNA cytometry is in stratifying grade 2 superficial (Ta, TI, TIS) tumors (16,30,36). With few exceptions, the majority of grade 1 tumors of the bladder are DNA diploid, whereas the majority of grade 3 tumors are DNA aneuploid (7,16,19,29,30,34,35,38).…”

DNA aberrations in urinary bladder cancer detected by flow cytometry and FISH

“…Despite evidence for a diagnostic significance ofDNA aneuploidy [5,6,24,26], DNA measurement has not become a routine examination in bladder cancer patients. This is probably due to the need for expensive equipment and specially trained personel to perform either flow cytometry (FCM) or DNA image cytometry.…”