[The diagnostic value of flow cytometric DNA analysis in bladder cancer--comparison with conventional cytology]

The aim of this research was to assess the clinical value of flow cytometry (FCM) compared with conventional cytology in the detection and diagnosis of bladder cancer. The practical application of FCM combined with cytology was also investigated. Seventy patients with bladder cancer and 50 without neoplastic disease of the urinary tract were studied. The exfoliated cells used for FCM-DNA analysis and cytology by the Papanicolaou technique were obtained from voided urine and subsequent bladder irrigation specimens. The false negative rates for urine cytology, irrigation cytology, urine FCM, and irrigation FCM were 36%, 38%, 14% and 13%, respectively. Corresponding false positive rates were 2%, 0%, 14%, and 18%. When the above-mentioned examinations were paired, the combination of urine cytology and urine FCM appeared to be the most acceptable way to secure a correct diagnosis. Using this combination, the false negative and false positive rates were 4%, and 16%, respectively. When three or four examinations were combined, the false negative fate could not be improved despite the fact that the false positive rate worsened. It is noteworthy that FCM-DNA analysis seems to be less reliable in patients who have inflammatory diseases of the urinary tract or a history of intravesical chemotherapy.