QUANTICYT - KARYOMETRIC ANALYSIS OF BLADDER WASHING FOR PATIENTS WITHSUPERFICIAL BLADDER-CANCER

Objectives. Quantitative cytology by image-analysis techniques enables objective interpretation of nuclear features in light microscopic ima ges. OUANTICYT, a quantitative karyometric cytology system, was used i n the follow-up of patients with superficial bladder cancer. Methods. From 1992 to 1995, 4137 samples from 1412 patients were obtained, At 1 -year follow-up after the initial bladder washing, a tumor recurrence rate of 21% was found. In this period, tumor progression to invasive d isease occurred in 1.6% of patients. Scoring of tumor by the QUANTICYT system was based on two nuclear features: the 2c deviation index and the mean of a nuclear shape feature: MPASS. Results. The method was fo und to be reproducible and superior to visual cytologic interpretation . QUANTICYT analysis of the bladder washings resulted in a score of lo w, intermediate, and high risk. In a multivariate analysis, highest gr ade of earlier tumor and OUANTICYT risk score were the best predictors of tumor recurrence and progression. For the easy application of OUAN TICYT analysis in daily routine, a report form that included patient h istory and DNA histogram was developed. Conclusions, QUANTICYT karyome tric analysis of bladder-wash material proved a useful, clinically app licable grading tool in the follow-up of patients with superficial bla dder cancer, with sufficient power to be used in decision-making in th e individual patient.