Intratumoral heterogeneity of DNA content in renal cell carcinoma and its prognostic significance

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Abstract
BACKGROUND A multiple sampling study was performed on 124 specimens of renal cell carcinomas to analyze the consistency and reliability of DNA measurements. The authors investigated intratumoral DNA heterogeneity and its role as a adverse prognostic factor for disease progression. METHODS DNA content was analyzed by flow cytometry on three different samples of the same tumor. The Cronbach α coefficient was used to assess the reliability and a Cox proportional hazards model was used to test the effect of DNA ploidy heterogeneity on time of disease progression. RESULTS The agreement among the DNA ploidy samples was high. The number of aneuploid findings increased significantly with the number of samples analyzed. The presence of non‐diploid cell populations was a significant adverse predictive value for disease progression. However, the authors were unable to demonstrate that intratumoral heterogeneity DNA content had any influence on the biological behavior of the tumor. CONCLUSIONS Determination of DNA ploidy based on single samples may be inaccurate. Spatial variation in DNA ploidy is a feature of renal cell carcinoma; however, its biologic significance remains to be demonstrated. Cancer 1999;86:664–71. © 1999 American Cancer Society.