Yu D S, Hsu C M, Chang S Y, Ma C P
Department of Surgery (Uro-Oncology Laboratory, Division of Urology), Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
J Formos Med Assoc. 1992 Feb;91(2):152-8.
Cell material from 79 cases of archival paraffin-embedded tumor specimens of newly diagnosed transitional cell carcinomas of the urinary bladder was studied retrospectively using rapid flow cytofluorometric DNA analysis. The male to female ratio was 62/17. The mean age at diagnosis was 65.3 +/- 10.8 years. Clinical characteristics, including survival, recurrence and progression were closely related to the histopathologic grading and tumor staging. The tumors were classified as diploid (DI = 0.9-1.1) or aneuploid. Total aneuploid occurrence was 46%. The aneuploid frequency for the various tumor grades was 25% for grade 1, 37% for grade 2 and 78% for grade 3. Stages Ta (O) and Tl (A) tumors differed from muscle-invasive tumors (T2-4) in that they had a lower frequency of aneuploid occurrence (34%, 41% vs 50%, 73%, and 75%). Multiple aneuploid stem cell lines had no influence on tumor grade or stage. The DNA ploidy was closely related to the five-year survival rate, the probability of tumor recurrence and progression. On the contrary, the modal nuclear size of the tumor cells had no correlation with histopathology or the clinical characteristics. Bladder tumors of an intermediate grade (grade 2) may be subdivided into two groups with different outcomes on the basis of flow cytometric characteristics. It is concluded that DNA flow cytometry can serve as an additional prognostic parameter for bladder cancer patients in addition to conventional histopathology.
采用快速流式细胞荧光DNA分析法，对79例新诊断的膀胱移行细胞癌存档石蜡包埋肿瘤标本的细胞材料进行回顾性研究。男女比例为62/17。诊断时的平均年龄为65.3±10.8岁。包括生存、复发和进展在内的临床特征与组织病理学分级和肿瘤分期密切相关。肿瘤分为二倍体（DI = 0.9 - 1.1）或非整倍体。非整倍体的总发生率为46%。不同肿瘤分级的非整倍体频率分别为：1级25%，2级37%，3级78%。Ta（O）期和T1（A）期肿瘤与肌层浸润性肿瘤（T2 - 4）不同，其非整倍体发生率较低（34%，41%对50%，73%和75%）。多个非整倍体干细胞系对肿瘤分级或分期无影响。DNA倍体与五年生存率、肿瘤复发和进展的概率密切相关。相反，肿瘤细胞的核大小模态与组织病理学或临床特征无关。基于流式细胞术特征，中级（2级）膀胱肿瘤可分为两组，预后不同。结论是，除了传统的组织病理学外，DNA流式细胞术可作为膀胱癌患者的一个额外预后参数。
