Flow DNA analysis in the characterization of carcinoma of the renal pelvis and ureter

A prospective study comprised operative specimens from 11 patients with transitional cell carcinoma of the renal pelvis or ureter. DNA analysis of the primary tumor and of multiple biopsy specimens from preselected sites of the surrounding urothelium was performed with flow cytometry. All Grade 3 tumors and 50% of the Grade 2 tumors were aneuploid, and the remainder were Grade 2 and diploid. All invasive tumors were aneuploid. Carcinoma in situ was found in some of the preselected biopsy specimens, all of which were aneuploid, from two patients. Close correlation thus was observed between aneuploidy and tumor invasiveness, whereas diploidy was seen only in noninvasive tumors with lower malignancy grade. Aneuploidy was also associated with increased risk of carcinoma in situ. The study indicated that DNA analysis may be useful for defining the malignant potential of urothelial tumors of the upper urinary tract more fully than conventional grading and staging permit.