Aaltomaa S, Lipponen P, Syrjänen K
Department of Surgery, University of Kuopio, Finland.
Anticancer Res. 1992 Jul-Aug;12(4):1281-6.
A series of 175 biopsies from primary tumours were subjected to immunostaining for proliferation cell nuclear antigen (PCNA) and histopathological analysis for prognostic factors in 175 women with breast cancer followed up for nine years. In normal breast epithelium, only occasional nuclei were positive for PCNA. In breast carcinomas, the fraction of nuclei positive for PCNA showed considerable intratumoural variation, usually being highest at the invasive tumour margins. The fraction of positive nuclei was significantly related to histological grade (p less than 0.001), histological type (p = 0.049) and tumor recurrence (p = 0.01). The fraction of positive nuclei predicted recurrence-free survival (p = 0.007) and overall survival (p = 0.0158) in univariate analysis. In the multivariate analysis including also the standard prognostic factors, the PCNA positivity predicted recurrence-free survival (p = 0.004) and overall survival (p = 0.030) independently. The results show that the light microscopic assessment of the growth fraction as determined by PCNA immunolabeling has independent prognostic value in breast carcinomas like some other (e.g. S phase fraction, mitotic index, Ki-67) previously characterized proliferation indices.
对175例原发性肿瘤活检样本进行增殖细胞核抗原（PCNA）免疫染色，并对175例乳腺癌患者的预后因素进行组织病理学分析，这些患者均接受了9年的随访。在正常乳腺上皮中，只有偶尔的细胞核PCNA呈阳性。在乳腺癌中，PCNA阳性细胞核的比例在肿瘤内存在相当大的差异，通常在浸润性肿瘤边缘处最高。阳性细胞核的比例与组织学分级（p<0.001）、组织学类型（p = 0.049）和肿瘤复发（p = 0.01）显著相关。在单变量分析中，阳性细胞核的比例可预测无复发生存率（p = 0.007）和总生存率（p = 0.0158）。在包含标准预后因素的多变量分析中，PCNA阳性独立预测无复发生存率（p = 0.004）和总生存率（p = 0.030）。结果表明，通过PCNA免疫标记确定的生长分数的光镜评估在乳腺癌中具有独立的预后价值，类似于其他一些先前已表征的增殖指数（如S期分数、有丝分裂指数、Ki-67）。
