COMPARISON OF HISTOLOGIC AND CYTOLOGIC SPECIMENS OF UROTHELIAL CARCINOMA WITH IMAGE-ANALYSIS - IMPLICATIONS FOR GRADING

OBJECTIVE: To compare DNA results obtained by each of three preparatio n types (cytologic smears or cytocentrifuge samples, tissue sections a nd nuclei extracted from paraffin-embedded tissue) on patients with pr imary urothelial cell carcinoma of the bladder. STUDY DESIGN: Cases we re selected for study based on the histologic diagnosis and the availa bility of corresponding bladder washing cytologic specimens. Five-micr ometer sections and nuclear extracts were prepared from biopsies. DNA analysis was accomplished by use of an image cytometer on the Feulgen- stained material. RESULTS: DNA content results correlated with both hi stologic and cytologic grade. Using a binary classification system, bl adder washings and thin tissue section results concurred in 40/43 pati ents. Nuclear extracts were performed on 27 of the biopsies. The DNA c ontent determined by nuclear extract agreed with the tissue section re sults for all 27 biopsies. CONCLUSION: All three specimen preparations yield comparable DNA content results using a binary DNA classificatio n scheme (diploid or aneuploid). Histologic grading can be enhanced wi th DNA content results, particularly in the heterogeneous, grade 2 gro up of urothelial carcinomas.