Lipponen P K, Eskelinen M J, Nordling S
Department of Pathology, University of Kuopio, Finland.
Eur Urol. 1991;20(4):311-4. doi: 10.1159/000471723.
DNA flow cytometry (FCM) was performed from multiple samples in 60 transitional cell bladder carcinomas (TCC) to detect intratumoral heterogeneity of DNA index (DI). The samples for analysis were selected randomly and they were paraffin-embedded peroperative biopsy specimens from the primary TCCs. Intratumoral heterogeneity of DI was found in 12 of 60 (20%) samples. All WHO grade I tumors were diploid whereas 12 of 41 (29%) WHO grade II-III tumors showed a heterogeneous DI. DI heterogeneity was related to WHO grade (p = 0.004), mitotic frequency (p = 0.002), inflammatory cell infiltration (ICI; p = 0.003) and nonpapillar growth pattern (p = 0.06). In multivariate analysis, the WHO grade (p = 0.027) and the degree of ICI (p = 0.041) were independently related to heterogeneous DI. The results show that (a) many of the WHO grade II-III TCCs are composed of diploid and aneuploid cell populations; (b) the presence of dense ICI and TCCs may lead to false diploid DI. Consequently, the analysis of multiple samples is recommended in WHO grade II-III tumors to detect aneuploidy particularly when dense ICIs are present.
对60例膀胱移行细胞癌（TCC）的多个样本进行了DNA流式细胞术（FCM）检测，以检测DNA指数（DI）的肿瘤内异质性。分析样本是从原发性TCC的手术活检标本中随机选取并石蜡包埋的。在60个样本中的12个（20%）发现了DI的肿瘤内异质性。所有WHO I级肿瘤均为二倍体，而41例WHO II - III级肿瘤中的12例（29%）显示DI异质性。DI异质性与WHO分级（p = 0.004）、有丝分裂频率（p = 0.002）、炎性细胞浸润（ICI；p = 0.003）和非乳头状生长模式（p = 0.06）相关。在多变量分析中，WHO分级（p = 0.027）和ICI程度（p = 0.041）与DI异质性独立相关。结果表明：（a）许多WHO II - III级TCC由二倍体和非整倍体细胞群组成；（b）密集ICI和TCC的存在可能导致假二倍体DI。因此，对于WHO II - III级肿瘤，建议分析多个样本以检测非整倍体，特别是在存在密集ICI的情况下。
