Studies on objective indicator for predicting malignant potential of bladder cancer.

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In as much as urotherrial cancer consists of a spectrum of diseases with diverse natural histories, the conventional morphological classifications provided by classical histology still remain the hallmarks in the decisionmaking process. In the present study, an attempt was made to develope the objective and quantitative parameter for determination of malignant potential of bladder cancer. We have found that flow cytometric deoxyribonucleic acid(DNA)/bromodeoxyuridine bivariate analysis can provide important information on the malignant potential of bladder cancer. Also was found that the proliferative rate of the tumor cells in tumor may have significant importance since the rate of DNA synthesis is directly rerated to the rate of tumor growth or to tumor involvement. Then, we have formulated a new grading system based on the histological grade and tumor proliferative activity determinated by the BrdU labeling index. Each tumor was given a score ranging from 1 to 52. Fourty-four patients with a score of 1 demonstrated a 100% three-year survival rate, compared to 42.9% for patients having a score greater than 1. Conversely, 26 patients with the highest score of 52 presented a three-year survival rate of 17.3%. These results suggest that the new grading system can be used as an indicator in decision-making or treatment choice of transitional cell carcinoma of the bladder.