Objective: To evaluate prospectively 90 consecutive cases of squamous cell carcinoma of penis, referred to our Institute, by flow cytometry analysis of cellular DNA content. To compare deoxyribonucleic acid (DNA) flow cytometry with clinical and pathological variables to determine the prognostic significance of this analysis to guide the selection of patients at high risk for development of lymph node metastases.
Patients and methods: We determined the nuclear DNA of tissues in fresh biopsy specimens of 80 patients diagnosed histologically as invasive squamous cell penile carcinoma and in fresh biopsy specimens of 10 patients with verrucous carcinoma of penis. Samples were analyzed with a FACScan flow cytometer, equipped with a doublet discrimination module, using the CellFIT software package for data acquisition and analysis.
Results: The DNA pattern was diploid in all samples excised from patients with verrucous carcinoma. According to histological type the frequency of aneuploidy was 5.5% (1 of 18) in well differentiated carcinoma, 28.8% (17 of 59) in moderately differentiated carcinoma and 66.6% (2 of 3) in poorly differentiated carcinoma.
Conclusion: The frequency of DNA aneuploidy showed correlation with histological type of invasive squamous cell carcinoma of the penis. Preliminary analysis suggests that patients with high DNA index may be at increased risk of metastatic involvement.