DNA cytophotometry in renal cell carcinoma: A significant prognostic factor?

We report on a prospective DNA cytophotometric study of 66 patients with re nal tumors, 61 of whom had renal cell carcinoma (RCC) (pT1-pT4, G1-G3). 16 of the patients had a metastasis at the time of diagnosis. Cell material fr om 1-5 specimens of each tumor was analyzed for intratumoral heterogeneity. The aim of the study was to evaluate the prognostic value of the following DNA parameters: DNA ploidy, DNA grade of malignancy (DNA MG), mean DNA, DN A index, 2c deviation index (2cDI), and 5c exceeding rate (5cER). In this s tudy 21% of the tumors were non-aneuploid, 79% were aneuploid; however; it proved possible to diagnose 38% of the total collective as aneuploid only b y analyzing several tumor areas. In five of 61 RCC patients who died during an observation period of 42 months, at least one area of the primary tumor was aneuploid Aneuploid primary tumors also accompanied the development of metastases and recurrent tumors in four of the 61 RCC patients. Only DNA 2 cDI was found to have a significantly positive clinical correlation with me tastasis (r = 0.261) during the clinical course. This was not true, however , for the histopathological parameters. Significantly positive correlations were found between the tumor stages and the following DNA parameters: mean DNA, DNA index, and 5cER. Histopathologic tumor grading showed a significa ntly positive correlation with DNA MG, mean DNA, and 5cER. Statistically th e mean values of all evaluated parameters were significantly higher in meta stasizing and recurrent RCCs than in nonmetastasizing carcinomas (p<0.05; t -test). DNA cytophotometry cannot substitute histopathologic prognosis. How ever; the analysis of various DNA parameters helps considerably in evaluati ng both the malignant potential of kidney tumors and the benign parenchyma of tumor-bearing kidneys.