Quanticyt: Karyometric analysis of bladder washing for patients with superficial bladder cancer

Objectives. Quantitative cytology by image-analysis techniques enables objective interpretation of nuclear features in light microscopic images. OUANTICYT, a quantitative karyometric cytology system, was used in the follow-up of patients with superficial bladder cancer. Methods. From 1992 to 1995, 4137 samples from 1412 patients were obtained, At 1-year follow-up after the initial bladder washing, a tumor recurrence rate of 21% was found. In this period, tumor progression to invasive disease occurred in 1.6% of patients. Scoring of tumor by the QUANTICYT system was based on two nuclear features: the 2c deviation index and the mean of a nuclear shape feature: MPASS. Results. The method was found to be reproducible and superior to visual cytologic interpretation. QUANTICYT analysis of the bladder washings resulted in a score of low, intermediate, and high risk. In a multivariate analysis, highest grade of earlier tumor and OUANTICYT risk score were the best predictors of tumor recurrence and progression. For the easy application of OUANTICYT analysis in daily routine, a report form that included patient history and DNA histogram was developed. Conclusions, QUANTICYT karyometric analysis of bladder-wash material proved a useful, clinically applicable grading tool in the follow-up of patients with superficial bladder cancer, with sufficient power to be used in decision-making in the individual patient.