Clinical evaluation of cell deoxyribonucleic acid content measured by flow cytometry in bladder cancer.

Abstract

We evaluated the clinical value of flow cytometry in bladder cancer. Deoxyribonucleic acid (DNA) content was measured by flow cytometry in 275 untreated patients with bladder tumor followed for 1 to 8 years. Four pathological parameters (stage, grade, observed vascular invasion and associated carcinoma in situ) and 3 flow cytometric parameters (ploidy, number of aneuploid cell lines and DNA index) were defined. Univariate survival analysis showed that every parameter, when considered separately, was a significant prognostic factor (p < 0.0001 in call cases). Multivariate analysis showed that stage (p < 0.0001), DNA index (p < 0.01) and associated carcinoma in situ (p < 0.05) were independent, significant prognostic factors. However, ploidy and DNA index enhanced prognostic information above the traditional stage and grade only in patients with a stage pT1, grade 3 tumor (p < 0.05). Retrospectively, different therapeutic decisions could have been made using DNA content only in 4% of cases. In patients with bladder cancer DNA content is an independent predictor of survival but its clinical usefulness is limited.