The application of flow cytometry to the assessment of tumor cell heterogeneity and the grading of human prostatic cancer: preliminary results.

A new method has been developed to assess quantitatively tumor cell morphology and tumor cell heterogeneity. Preliminary results suggest that this method may be capable of predicting the metastatic potential of a tumor based upon analysis of a biopsy sample. A flow cytometric grading index was established based upon the mean and variance in perpendicular and forward light scatter. The mean was included to assess the tumor as a whole. The variance was included to assess the range of morphological heterogeneity within the tumor. This flow cytometric grading index has allowed for the accurate prediction of the ultimate pathological stage in a small series of human prostatic cancers obtained at the time of radical retropubic prostatectomy and lymph node dissection. Patients with high flow cytometric index values had seminal vesicle invasion and capsular penetration by prostatic cancer. Those with intermediate index values had capsular penetration only. The patient with a low index value had a small cancer confined totally to the surgical specimen.