Detection of bladder carcinoma in females by flow cytometry and cytology

Utility of Flow Cytometry Analysis in the Detection of Nonhematologic Neoplasms: An Overview

Flow cytometry analysis has stood the test of time as a powerful tool in the assessment of hematologic neoplasms. The role of flow cytometry has expanded to evaluate various nonhematologic neoplasms encountered in body cavity malignant effusions, lymph nodes, and other body sites. This review explores the use of routine antibody panels as well as specially designed multicolor antibody panels that have been investigated by different groups and reported in the literature for evaluating nonhematologic neoplasms. In this context, the limitations, pitfalls, future directions, and promising applications of flow cytometry analysis are also discussed.

Environmental Monitoring of PAHs Exposure, Biomarkers and Vital Status in Coke Oven Workers

A follow-up study of a cohort of workers from a coke plant compared with a control group from the same industrial area was conducted in 2019. The recruitment and environmental and biomarker measurements were performed during 1993/1994. The environmental concentrations of polycyclic aromatic hydrocarbons (PAH), B(a)P, pyrene and nitro-PAH were measured. Personal data were collected via an individual semi-structured questionnaire by a trained physician. All biomarkers were measured after a specific blood drawing for every test. Significant risks (ORs) were observed for nitro-PAH (≥0.12 µg/m³) [OR = 7.96 (1.01–62.82)], urinary 1-hydroxypyrene (1-OHpy) (≥0.99 µmoles/moles of creatinine) [OR = 11.71 (1.47–92.90)], PAH DNA adducts (P³²) (≥2.69 adducts/10⁸ nucleotides) [OR = 5.46 (1.17–25.58)], total nitro-PAH hemoglobin adducts (≥161.68 fg/µg of Hb) [OR = 5.92 (1.26–27.86)], sister chromatid exchange (SCE) with TCR (≥377.84 SCE/cell chromosomes) [OR = 13.06 (3.95–93.10)], sister chromatid exchange with T (≥394.72 total SCE) [OR = 13.06 (3.95–93.10)], and sister chromatid exchange with X (≥8.19 mean SCE) [OR = 13.06 (3.95–93.10)]. Significant risk of death for all causes and chromosomal aberrations (48 h) (OR = 7.19 [1.19–43.44]) or micronuclei in culture at 48 h (OR = 3.86 [1.04–14.38]) were also found.

Applications of flow cytometric DNA analysis to diagnostic cytology

Flow cytometry is a rapid method for measuring DNA content. Its high sensitivity and specificity in detecting transitional cell carcinomas in bladder washings should make it a routinely applied adjunct to cytology once universal laboratory standards are firmly established. Diagnostic and prognostic information on solid tumors can be obtained at least as reliably on fine-needle aspirations as on surgically resected specimens. At the present time, the sensitivity of FCM in the evaluation of effusions, peritoneal washings, and CSF is relatively low, and although in some cases malignant cells in these specimens that are missed by conventional cytology are detected by FCM, the number of such cases is small. Investigation continues into the application of FCM to the screening of cervical specimens.

Bladder wash flow cytometry in transitional cell carcinoma: useful or misleading?

To evaluate the practical usefulness of flow cytometry (FC) applied to bladder wash specimens for the diagnosis of transitional cell carcinoma (TCC), a study was conducted on a series of 101 cases comprising 60 patients with tumor or with past history of TCC, and a control group of 41 patients undergoing cystoscopy for causes other than TCC in which the absence of tumor was confirmed after 1 year of follow-up. When results of the 33 patients with tumor were compared with those of the control group, FC gave low specificity and positive predictive values (54% and 58%, respectively). Conventional cytologic study was superior to FC in this setting. Although the combination of both techniques increased the sensitivity for low-grade tumors, specificity remained lower than that of cytologic study alone. Otherwise, when considering only the cases with a past history of TCC, results of FC were superior to those of cytologic examination, and the combination of both techniques gave high sensitivity and negative predictive values (94% and 93%, respectively). In conclusion, the use of FC in a general diagnostic setting could be misleading, whereas in the follow-up of patients with a history of TCC it becomes a useful adjunct to cytologic study in order to obtain a high diagnostic performance that could allow cystoscopies to be spaced out in these patients.

Dna Flow Cytometry in Bladder Tumours: New Perspectives

An International “DNA Cytometry Consensus Conference” was held in October 1992, in Maine (USA): The Author reports the opinions concerning bladder tumours, expressed by the experts at the Conference. Models for future studies with Flow Cytometry are also reported.

Flow Cytometry Analysis in Voided Urine of Patients with Bladder Cancer

Flow cytometry is known to be able to give a quantitative evaluation of the DNA of cellular populations (grade of ploidy), as well as to estimate the percentages of phases (S + G2M) providing useful information about the pathology in question and its aggressivity. This method has been applied in diagnosing patients with bladder cancer, using their voided urine and comparing with urine cytology. Our data, from 59 patients, indicate flow cytometry utility in diagnosing bladder cancer; in fact there is an excellent correlation between the urinary cytology and the DNA content in cytometry which increases in higher grade bladder cancer. The sensitivity of CFM is in the range of 92% to 94%, and is superior to that of conventional voided urine cytology (range 64% to 84%). It is felt that cytofluorometric analysis permits a reliable evaluation of voided urine, not only at first diagnosis, but especially during follow-up.

Centrifugal separation of carcinoma or atypical cells in voided urine

A simple density gradient method was used to separate atypical and cancer cells from non-cancer cells in voided urine from patients with transitional cell atypia (moderate and grave atypia) and bladder cancer (squamous cell carcinoma and transitional cell carcinoma). Prior to cell separation, the Saccomanno preserved cells were dispersed by homogenization. After cell separation (5 min x 1400 rpm), atypical and cancer cells were enriched up to 20-fold. Also, most of the leucocytes (68-98%) and squamous cells (47-82%) were absent from density gradient specimen fractions containing the largest percentages of atypical and cancer cells. Peak purity ranges of atypical or cancer cells from different sample classes showed a large degree of overlap. This permitted the pooling of density gradient fractions enriched for atypical or cancer cells, thus increasing the efficiency of the method. Also, following centrifugation, the Papanicolaou-stained specimen fractions showed less background staining than the unprocessed controls, and the cells retained diagnostic morphologic features. We infer that this method may be a useful, low-cost approach for the morphologic study of developing cancers, not only from the urinary bladder, but also from the respiratory tract.

Is voided urine suitable for flow cytometric DNA analysis?

Samples of bladder washings are frequently used to provide cellular material for flow cytometric DNA analysis. Since voided urine is a potential source of similar material, the aim of this study was to determine whether voided urine yields satisfactory specimens. We compared the qualitative results of flow cytometric DNA analysis of the cells in 53 specimens of voided urine and 109 samples of bladder washings; 45% (24/53) of urine specimens gave satisfactory DNA histograms compared with 93% (101/109) of bladder washings. This difference was apparent regardless of whether the bladder contained a tumour. It was concluded that bladder washings provide superior material for flow cytometric DNA analysis and that flow cytometric DNA analysis of freshly voided urine may have deficiencies which preclude its use in routine clinical practice.