腎細胞癌におけるProliferating cell nuclear antigenの発現と予後の関係について : 病理組織学所見および核DNA量との比較

Abstract

腎細胞癌100例を対象とし検討した. 1)PCNA陽性率は, grade, stageと相関し, さらにgrade 2群を予後の異なる2つのsubgroupに細分可能で, PCNA陽性率は従来の病理組織学的な予後規定因子を補助しうる, 重要な予後規定因子である. 2)DNA aneuploid群はDNA diploid群に対し予後不良の傾向にあったが有意差はなかった.腎細胞癌にはDNA heterogeneityを示すものがあり, DNA ploidy解析は, 1腫瘍につき1個の検体で評価した場合, 予後規定因子にはならなかった

In the present study the prognostic value of proliferating cell nuclear antigen (PCNA) index and tumor DNA content were evaluated in 100 patients with renal cell carcinoma. The survival rate of patients with aneuploid tumors was not significantly different from that of those with diploid tumors. DNA ploidy could not be a prognostic factor. PCNA expression was determined by immunohistochemical staining using the PC10 clone. PCNA indices ranged from 2.6 to 33.6% with mean indices of 10.2, 15.7 and 27.9% for grades 1 to 3. There was a significant difference between the indices of each grade of tumor. Patients with a PCNA index of less than 13.6% had a longer survival time than the patients having tumors with a PCNA index of more than 13.6% (p < 0.05). Furthermore, within the group of grade 2 tumors, patients with a lower PCNA index had a significantly better prognosis (p < 0.05). Our findings demonstrated that the PCNA index provides significant prognostic information for renal cell carcinoma.