Cytof luorometric Evaluation of Nuclear DNA Content Distribution in Renal Neoplasms Treated by Conservative Surgery

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Abstract
The prognostic value of nuclear DNA content in 21 patients who underwent conservative surgery for renal tumors was the object of a retrospective study. Cytofluorometric evaluation of nuclear DNA content distribution was performed on smears obtained from 50-µm thick histologic sections prepared with the Hedley technique, using a Leitz MPVII microspectrophotometer. The DNA indexes were plotted in the form of frequency histograms. DNA measurements were repeated by a cell image analysis system (CAS 200; Becton Dickinson) in 16/21 cases. Nuclear DNA content was diploid in 12 cases, triploid in 4, tetraploid in 2 and multiclonal in 3. No statistically significant correlation was found between ploidy and tumor stage and size, using Kendall’s tau test, while there was a significant correlation between tumor ploidy and nuclear grade (p < 0.01). Excluding 2 postoperative deaths, with an average follow-up of 54 months, tumor diffusion was observed in 2 patients (1 with multiclonal and 1 with triploid DNA content) and a local recurrence in a patient with a triploid tumor. Of the remaining 16 no evidence of disease (NED) cases, 10 have a diploid DNA tumor content, 2 diploid, 2 tetraploid and 2 multiclonal. It is concluded that even after conservative surgery for renal neoplasms a diploid DNA content is a favorable prognostic factor. A completely negative prognostic impact of nondiploid tumors is not confirmed, since although all three negative events occurred in this group, there are also 4 NED patients with respectively 70, 46, 43 and 40 months’ follow-up.

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