Flow cytometric measurements of deoxyribonucleic acid ploidy and proliferative activity for evaluating malignant potential of human bladder cancers.

Flow cytometric bromodeoxyuridine/deoxyribonucleic acid (DNA) bivariate analysis for transitional cell carcinoma of the human bladder tumor was performed to evaluate whether or not this technique can determine the malignant potential of these tumors. In vitro bromodeoxyuridine incorporation into the tumor cells, which were obtained from biopsy or cystectomy, was carried out by 1-h bromodeoxyuridine incubation under hyperbaric oxygen. Flow cytometric DNA aneuploidy was designated when distinctly different cell peaks were presented on the basis of DNA histograms. Bromodeoxyuridine-labeled cells were determined as the percentage in the entire cell population (Labeling index: LI). Of the total of 100 tumors, 45 tumors demonstrated DNA diploidy with a mean bromodeoxyuridine LI of 4.9 +/- 3.0%. On the other hand, the remaining 55 DNA aneuploid tumors featured a mean bromodeoxyuridine LI of 13.5 +/- 8.6%. Respectively observed in grades 1, 2, and 3, tumors were 26.7% aneuploidy (4 of 15) with a mean bromodeoxyuridine LI of 4.8 +/- 3.0%, 45.9% aneuploidy (28 of 61) with a mean bromodeoxyuridine LI of 8.5 +/- 7.0%, and 95.8% aneuploidy (23 of 24) with a mean bromodeoxyuridine LI of 15.7 +/- 8.9%. When the tumors were classified as superficial tumor and muscle-invaded tumor, all muscle-invaded tumors exhibited DNA aneuploidy with a mean bromodeoxyuridine LI of 17.2 +/- 8.5%, which was statistically significantly higher than those of superficial DNA aneuploid tumors having a 9.4 +/- 6.7% bromodeoxyuridine LI. Moreover, 66 patients with low LI tumors had a 3-year survival rate of 96.1% compared with 38.1% for 34 patients with high bromodeoxyuridine-LI tumors, which was statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)