Flow cytometric deoxyribonucleic acid analysis of primary and metastatic human renal cell carcinoma.

The deoxyribonucleic acid profiles of 54 renal cell carcinoma specimens (43 primary and 11 metastatic tumors) from 50 patients are reported. Deoxyribonucleic acid 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 deoxyribonucleic acid aneuploidy (presence of a distinct aneuploid stemline) was 74.1 per cent for all tumors and 77.3 per cent 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. When deoxyribonucleic acid 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. However, a larger patient population (especially patients with early stage disease) and a longer followup will be required to determine the prognostic role of flow cytometry deoxyribonucleic acid 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 deoxyribonucleic acid profiles in renal cell carcinoma are warranted and should improve our understanding of the biological and clinical behavior of this tumor.