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6th ESACP Congress, Heidelberg, April 7-11, 1999 |
A062
BACKGROUND: Effective noninvasive methods for monitoring bladder cancer
patients and screening for bladder cancer, showing better performance than
the methods currently in use would be desirable in order to detect urothelial
cancers at an early, easily treatable stage. A rapidly hydrolyzed component
of nuclear DNA has been described whose increase is linked to malignancy.
Quantitative determination of acid labile DNA has been successfully applied
to detect other neoplasms. This study investigates the potential of this
method in detecting Transitional Cell Carcinomas. METHODS: Touch
imprints of transurethral resection material of 62 cases with non-malignant
urothelium (control group including reactive changes) and 94 cases of bladder
cancer were analyzed. The full Feulgen hydrolysis profiles of the
non-malignant and malignant urothelial cells were compared by measuring the
staining density of the nuclei using digital image analysis after various
hydrolysis times. 20 cells were sampled randomly out of the cells measured
for calculation of the mean optical density (MOD). The MOD of each time was
used to build the hydrolysis profile of a case. RESULTS: A hydrolysis
time of 10 minutes turned out to be most discriminative between control and
cancer cases. Applying a single threshold of MOD 101 resulted in a test
sensitivity of 95,7%, a specificity of 94,4%, a positive predictive value
of 98,3%, a negative predictive value and an area under the ROC curve of 0,97.
CONCLUSIONS: The results of this pilot study suggest that measurement
of the rapidly hydrolyzed component of DNA present in the nuclei of bladder
urothelium offers a highly sensitive and reliable supplement to the
qualitative and subjective procedures in existing cytology.
QUANTITATIVE ASSESSMENT OF BLADDER CANCER BY ACID LABILE DNA ASSAY
Gschwendtner A, Mairinger Th
Dept. Pathology, University of Innsbruck, Innsbruck, Austria