PRIMARY NONURACHAL ADENOCARCINOMA IN THE BILHARZIAL URINARY-BLADDER -DEOXYRIBONUCLEIC-ACID FLOW CYTOMETRIC AND MORPHOLOGIC CHARACTERIZATION IN 93 CASES

Objectives: To characterize adenocarcinomas of the urinary bladder by their DNA profiles and their proliferative properties. Methods: Primar y nonurachal adenocarcinomas, found in 93 patients with bilharzial bla dder carcinomas, were studied using DNA flow cytometry. Tumor ploidy a nd S-phase fraction were related to tumor gralde, stage, cell type, an d lymph node status. Results: Aneuploidy with high S-phase fractions, found in 90% of the tumors, demonstrates the high malignancy potentia I of these tumors, the majority of which were found to be muscle-infil trative. There were no relationships between ploidy or S-phase fractio n and tumor grade and stage. Lymph node metastases, present in 24% of the 93 patients, were found exclusively in nontetraploid aneuploid tum ors with high S-phase fractions exceeding 10%. Paraffin-embedded tissu es compared with fresh material gave the same information on ploidy, w hereas bladder washing did not provide adequate information. Conclusio ns: The high aggressiveness of adenocarcinomas in the biharzial bladde r is confirmed and can be explained by their proneness to develop gros s chromosomal aberrations combined with high cell proliferation. (C) 1 998, Elsevier Science Inc. All rights reserved.