Nakae S, Nakamura T, Ikegawa R, Yoshioka H, Shirono J, Tabuchi Y
Department of Surgery, Hyogo Medical Center for Adults, Akashi, Japan.
J Surg Oncol. 1998 Sep;69(1):28-35. doi: 10.1002/(sici)1096-9098(199809)69:1<28::aid-jso6>3.0.co;2-m.
Information on cellular proliferation is gaining importance for predicting prognosis in several cancers. To clarify the clinicopathological significance of argyrophilic nucleolar organizer region (AgNOR), proliferating cell nuclear antigen (PCNA), and DNA ploidy pattern, we studied their correlations with clinicopathological factors in colorectal cancer.
Fifty-two patients with colorectal cancer were examined by AgNOR staining, immunohistochemical study of PCNA expression, and DNA flow cytometry.
The AgNOR score and the PCNA labeling rate (PCNA LR) were significantly higher in patients with deep invasion (P = 0.0072, P = 0.0355), liver metastasis (P = 0.0022, P = 0.0001), and Dukes D classification (P = 0.0002, P = 0.0001) than in patients without these factors. In patients with high AgNOR score (>3.83) or with high PCNA LR (>48.8), prognosis was significantly worse (P = 0.0002, P = 0.0123) than in those with low AgNOR score (<3.83) or in those with low PCNA LR (<48.8), respectively. No significant association was observed between AgNOR score and PCNA LR. Combined analysis revealed that the survival curve for patients with high AgNOR score and high PCNA LR was significantly lower (P = 0.0156) than that for patients with high AgNOR score and low PCNA LR. There was no significant correlation between DNA ploidy pattern and clinicopathological findings.
PCNA LR and AgNOR score were correlated not only with local progression but also with metastasis. Their determination provided useful prognostic information, and these parameters are probably independent. Their simultaneous determination was useful for accurate evaluation of prognosis. The value of DNA ploidy pattern was uncertain.
细胞增殖信息在多种癌症预后预测中的重要性日益凸显。为阐明嗜银核仁组成区（AgNOR）、增殖细胞核抗原（PCNA）及DNA倍体模式的临床病理意义，我们研究了它们与结直肠癌临床病理因素的相关性。
对52例结直肠癌患者进行AgNOR染色、PCNA表达的免疫组化研究及DNA流式细胞术检测。
深度浸润（P = 0.0072，P = 0.0355）、肝转移（P = 0.0022，P = 0.0001）及Dukes D分期（P = 0.0002，P = 0.0001）患者的AgNOR评分及PCNA标记率（PCNA LR）显著高于无这些因素的患者。AgNOR评分高（>3.83）或PCNA LR高（>48.8）的患者，其预后分别显著差于AgNOR评分低（<3.83）或PCNA LR低（<48.8）的患者（P = 0.0002，P = 0.0123）。未观察到AgNOR评分与PCNA LR之间存在显著关联。联合分析显示，AgNOR评分高且PCNA LR高的患者的生存曲线显著低于AgNOR评分高但PCNA LR低的患者（P = 0.0156）。DNA倍体模式与临床病理结果之间无显著相关性。
PCNA LR和AgNOR评分不仅与局部进展相关，还与转移相关。它们的测定提供了有用的预后信息，且这些参数可能是独立的。同时测定它们有助于准确评估预后。DNA倍体模式的价值尚不确定。
