TRANSITIONAL-CELL CARCINOMA OF THE RENAL PELVIS AND URETER IN TAIWAN - DNA ANALYSIS BY FLOW-CYTOMETRY

Background. The incidence of upper urinary tract tumors is relatively high in southern Taiwan. DNA analysis by means of flow cytometry is no t well investigated with regard to tumors of the upper urinary tract a nd the differences in DNA ploidy between transitional cell carcinomas in endemic and nonendemic areas.Methods. A retrospective nuclear DNA p loidy analysis by flow cytometry comprised 41 formaldehyde solution-fi xed, paraffin-embedded tissue specimens of transitional cell carcinoma of the renal pelvis and ureter. The preparation of nuclear suspension s from paraffin-embedded tissue blocks and staining were modified by m eans of the techniques of Hedley and Vindelov. Results. There was no s tatistical correlation between DNA ploidy, histologic grade, and patho logic stage; however, 82% of the DNA nondiploid tumors showed tumor pr ogression. In contrast, only 46% of the DNA diploid tumors revealed tu mor progression. Among Grade 2 tumors, 85% of the DNA nondiploid tumor s showed postoperative tumor progression, whereas only 31% of the DNA diploid tumors showed tumor progression. Seventy-nine percent of the n ondiploid patterns were present in patients native to the Pa Chang Val ley, where the so-called ''blackfoot disease'' and urothelium tumor ar e endemic, whereas only 22% appeared in patients living in other areas . Conclusions. DNA flow cytometry can identify a group of patients wit h poor outcome unpredictable by pathologic examination, and is an impo rtant tool in research into the pathogenesis of cancer.