TRANSITIONAL-CELL CARCINOMA OF THE BLADDE R - EVALUATION OF PROGNOSTIC FACTORS

This study evaluates prognostic factors in 25 patients with transition al cell carcinoma (TCC) of the bladder with a minimum follow up of two years. Histologically there were 12 patients with grade I tumors acco rding to the Mostofi's classification, 10 patients with grade II lesio ns and 3 grade III. The course of the grade I and II tumors was simila r and the grade III worse. According to stage, there were 11 patients stage 0, 8 stage A, 3 stage B and 3 stage C. Patients with all stages recurred but only those with stage B and C died of their disease. In 1 8 patients the expression of the beta subunit of HCG and of the blood group isoantigens was demonstrated by immunohistochemistry. There were 8 negative cases and 10 positive for the beta subunit of HCG and 10 n egative and 8 positive for the blood group isoantigens. DNA analysis w as done with an image analyzer on cytological smears of the urine in t he 25 cases after decolorization of the smears and Feulgen staining. T here were 5 diploid and 25 aneuploid cases. The DNA malignancy grade 3 was determined with a range between 0.100 and 2.689 and the number of events more than 5c (5N). The presence of HCG, aneuploid tumors, a ma lignancy grade higher than 0.500 and the presence of events more than 5c were statistically significant unfavorable prognostic factors. The presence of blood group isoantigens was associated with a better evolu tion of the tumor but did not reach statistical significance. Our work shows the value of such studies to better and more objectively define the behaviour of TCC of the bladder, specially in low grade lesions.