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

尽管尿路癌由一系列具有不同自然病史的疾病组成，但经典组织学提供的传统形态分类仍然是决策过程中的标志。本研究试图建立判断膀胱癌恶性潜能的客观定量指标。我们发现，流式细胞仪脱氧核糖核酸(DNA)/溴脱氧尿苷双变量分析可以为膀胱癌的恶性潜能提供重要信息。研究还发现，肿瘤细胞的增殖率可能具有重要意义，因为DNA合成的速度直接关系到肿瘤的生长速度或肿瘤的受累程度。然后，我们制定了一种新的分级系统，基于BrdU标记指数确定的组织学分级和肿瘤增殖活性。每个肿瘤的得分从1到52不等。评分为1的44例患者三年生存率为100%，大于1的患者为42.9%。反之，最高评分为52的26例患者的三年生存率为17.3%。提示新的膀胱移行细胞癌分级系统可作为膀胱移行细胞癌的决策或治疗选择的指标。

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.