PROGNOSTIC IMPLICATION OF PROLIFERATIVE MARKERS MIB-1 AND PC10 IN ESOPHAGEAL SQUAMOUS-CELL CARCINOMA

BACKGROUND, Proliferative markers are related to tumor behavior. The c ommonly used markers are proliferating cell nuclear antigen (PCNA) and Ki-67. The aim of this study is to evaluate the usefulness of MIB-1 ( for Ki-67) and PC10 (for PCNA) in the assessment of the clinicopatholo gic features and prognosis in patients with esophageal squamous cell c arcinoma. METHODS. One hundred patients (88 males, 12 females; mean ag e, 63 years [range, 39 to 83 years]) with surgically resected esophage al squamous cell carcinoma (32 well differentiated, 51 moderately diff erentiated, and 17 poorly differentiated) were studied. The clinicopat hologic features and survival data of these patients were noted. Repre sentative tissue was collected from each tumor and immunohistochemical preparations for MIB-1 and PC10 were made. RESULTS. The percentages o f cells that tested positive for PC10 and MIB-1 were much higher in tu mor cells than in nonneoplastic cells. The pattern of expression of bo th markers varied with the differentiation of the tumor. The results o bserved with MIB-1 staining were better than those with PC10; because MIB-1 had less background staining, as well as stronger and more unifo rm positive signals compared with PC10. Thus, further investigation wa s performed on MIB-1-stained sections. The tumor cell MIB-1 scores ran ged from 169 to 964 positive cells per 1000 cells (mean 598 +/- 211; m edian, 636). Although it was significantly associated with the differe ntiation of the tumor (P = 0.0001), the score had no significant relat ionship to the tumor size, location, or stage, or to the patients' age and sex. The prognosis depended on the size and stage of the lesion. In Stage III lesions (n = 83), patients with MIB-1 scores below 300 ha d longer actual survival rates than those with a score of 300 or above . However, the survival rates of patients in the latter group were bet ter if the greatest dimension of the tumor diameter was 7.5 cm or less . CONCLUSIONS. Proliferative activity in esophageal squamous cell carc inoma, as defined by the MIB-1 immunohistochemical method, is signific antly related to tumor differentiation. It is also potentially valuabl e as a prognostic marker in addition to its use in tumor staging and s ize. (C) 1996 American Cancer Society.