Seregard S
Division of Ophthalmic Pathology and Oncology, St. Erik's Eye Hospital, Stockholm, Sweden.
Am J Ophthalmol. 1993 Jul 15;116(1):93-7. doi: 10.1016/s0002-9394(14)71751-9.
Expression of proliferating cell nuclear antigen, a DNA polymerase delta auxiliary protein, was studied in 20 specimens from 20 patients with conjunctival malignant melanoma by means of the total number of cells that showed immunoreactivity per square millimeter. The countings were shown to be reproducible with minimal intraobserver variability. In a multifactor analysis of variance (ANOVA) that adjusted for possible confounders, patients who subsequently died of metastatic disease had significantly higher counts of cells that were positive for proliferating cell nuclear antigen per square millimeter (P = .0011) than patients with a minimum survival of five years without clinical signs of metastatic disease. A multivariate Cox regression model confirmed the independent prognostic value (P = .048) of the cell counts. Individual hazard ratios were estimated in a final Cox model and two groups of patients with low and high hazard ratios were formed. Five-year cumulated survival proportions of the two groups were 90% and 60%, respectively. The total count of cells displaying immunoreactivity for proliferating cell nuclear antigen per square millimeter may be used as a prognostic indicator in patients with conjunctival melanoma.
通过每平方毫米显示免疫反应性的细胞总数，对20例结膜恶性黑色素瘤患者的20个标本进行了增殖细胞核抗原（一种DNA聚合酶δ辅助蛋白）的表达研究。计数显示具有可重复性，观察者内部变异性最小。在对可能的混杂因素进行校正的多因素方差分析（ANOVA）中，随后死于转移性疾病的患者每平方毫米增殖细胞核抗原阳性细胞计数显著高于无转移性疾病临床体征且至少存活五年的患者（P = .0011）。多变量Cox回归模型证实了细胞计数的独立预后价值（P = .048）。在最终的Cox模型中估计了个体风险比，并形成了两组风险比低和高的患者。两组的五年累积生存率分别为90%和60%。每平方毫米显示增殖细胞核抗原免疫反应性的细胞总数可作为结膜黑色素瘤患者的预后指标。
