Flow Cytometric Deoxyribonucleic Acid Analysis of Primaryl and Metastatic Human Renal Cell Carcinoma

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Abstract
The DNA profiles of 54 renal cell carcinoma specimens (43 primary and 11 metastatic tumors) from 50 patients are reported. DNA ploidy and the proportion of cells in the S phase (S index) were determined by flow cytometry. Of the patients 44 had advanced disease (stages III and IV). The frequency of DNA aneuploidy (presence of a distinct aneuploid stemline) was 74.1% for all tumors and 77.3% for stages III and IV tumors. The percentage of aneuploid tumors did not vary significantly among the various histological types, between stages III and IV tumors, or between primary and metastatic tumors. S indexes for aneuploid tumors were significantly higher than for diploid tumors. DNA ploidy of the tumor alone was considered with respect to survival, there appeared to be a slight survival advantage for patients with diploid tumors compared to those with aneuploid tumors. Alarger patient population (especially patients with early stage disease) and a longer followup will be required to determine the prognostic role of flow cytometry DNA analysis of renal cell carcinoma. Flow cytometry analysis of 4 primary renal tumors and their subsequent metastases revealed concordance in ploidy in 3 specimens. In 1 patient the primary tumor showed a diploid pattern whereas the subsequent metastasis showed 2 aneuploid stemlines. Possible explanations for this observation are listed. Further flow cytometry studies of DNA profiles in renal cell carcinoma are warranted and should improve the understanding of the biological and clinical behavior of this tumor.