Acridine orange flow cytometric analysis of renal cell carcinoma. Clinicopathologic implications of RNA content

To explore the potential role that ribonucleic acid (RNA) content analysis may have in the assessment of primary renal cell carcinomas (RCC), biparametric flow cytometric (acridine orange) measurements for DNA/RNA were obtained on 108 fresh neoplastic specimens. RNA content was divided into low and high groups, based on the average RNA content in normal kidney controls. High RNA content was significantly correlated with aneuploidy, high proliferative index, high nuclear grade, cytoplasmic granularity, and large tumor size. No correlation was found between RNA content and patients' sex, race, and clinical stage of the carcinomas. When diploid RCCs were separately analyzed, high RNA content was correlated with high nuclear grade, large tumor size, high clinical stage, and cytoplasmic granularity. There was no correlation between RNA content and the patient's sex or race or the neoplasm's proliferative index. Of the 16 patients that relapsed (5 diploid and 11 aneuploid), four of the diploid and all 11 aneuploid neoplasms displayed high RNA content. The authors' data show that RNA may be a valuable objective and quantitative parameter in the clinicopathologic assessment of RCC.