FLOW CYTOMETRIC MEASUREMENTS OF DEOXYRIBONUCLEIC-ACID PLOIDY AND PROLIFERATIVE ACTIVITY FOR EVALUATING MALIGNANT POTENTIAL OF HUMAN BLADDERCANCERS

Flow cytometric bromodeoxyuridine/deoxyribonucleic acid (DNA) bivariat e 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 in corporation into the tumor cells, which were obtained from biopsy or c ystectomy, was carried out by 1-h bromodeoxyuridine incubation under h yperbaric oxygen. Flow cytometric DNA aneuploidy was designated when d istinctly different cell peaks were presented on the basis of of DNA h istograms. Bromodeoxyuridine-labeled cells were determined as the perc entage in the entire cell population (Labeling index: LI). Of the tota l of 100 tumors, 45 tumors demonstrated DNA diploidy with a mean bromo deoxyuridine LI of 4.9 +/- 3.0%. On the other hand, the remaining 55 D NA aneuploid tumors featured a mean bromodeoxyuridine LI of 13.5 +/- 8 .6%. Respectively observed in grades 1,2, and 3 tumors were 26.7% aneu ploidy (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 ane uploidy with a mean bromodeoxyuridine LI of 17.2 +/- 8.5%, which was s tatistically significantly higher than those of superficial DNA aneupl oid tumors having a 9.4 +/- 6.7% bromodeoxyuridine LI. Moreover, 66 pa tients 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, whi ch was statistically significant. These results indicate that bromodeo xyuridine/DNA bivariate analysis provides appropriate quantitative and objective information for evaluating the malignant potential of human bladder cancers-information which can be used for decision making in or modification of therapy.