FLOW CYTOMETRY NETWORK FOR BLADDER CANCER

Investigation of flow cytometric (FCM) analysis of urinary bladder
barbotage specimens has demonstrated that FCM is useful and practical for
monitoring recurrences and response to therapy in bladder carcinoma
patients. We believe, however, that before this technology is offered on a
nationwide basis, it is essential to optimize and standardize it, taking
into account recent cytometric innovations and, especially, advances in the
understanding of neoplastic and preneoplastic diseases of the urinary
bladder. First, we will develop a method to detect a wider range of
urologic neoplasia, particularly low grade papillary and flat preneoplastic
lesions without detectable ploidy abnormalities. Potentially, our approach
will correct some of the most serious technical drawbacks associated with
the current cytochemistry and instrumentation, including unsuitability for
fixed cells or cells recovered from voided urine, low resolution and
sensitivity for abnormal DNA stemlines, high nonspecific staining of
certain cell types, and lack of widespread laboratory acceptance of the
technique. We propose to develop a method which will employ simple, widely
acceptable cytochemistry and a standard commercially available instrument.
However, to determine the optimal combination of cellular parameters for
our method, we will also perform sophisticated multiparameter analysis
directly comparing three or more fluorescence parameters on the same
cells. Finally, our studies will improve the scientific basis of FCM
studies by comparing FCM with cytogenetics on the same patients and
defining the cellular abnormalities detectable by FCM which are
characteristic of the full range of preneoplastic bladder lesions.