IMMUNOHISTOCHEMICAL STUDY OF PCNA AND P53 IN PRIMARY LIVER-CANCER - AN IMPLICATION FOR PROGNOSIS AND TREATMENT

On the basis of the biologic behaviors of primary liver cancer (PLC), the intrahepatic recurrence rate in patients after hepatectomy is very high. With the aim to decrease the recurrence rate of PLC patients af ter hepatectomy, 102 specimens obtained from PLC were examined immunoh istochemically using anti-p53 and anti-PCNA monoclonal antibodies. Mut ations of p53 alterations in exons 5-8 of the gene were examined using the single-stranded conformational polymorphism analysis of polymeras e chain reaction products (PCR/SSCP) method in 60 cases of the 102 spe cimens. This paper analyzes the different pathologic features, labelli ng index of PCNA, expression of P53 and mutations of p53 alterations i n exons 5-8 of the gene in PLC and its values for clinical treatment. The results show that the labelling index of PCNA has no statistical d ifference with tumor size, capsule formation, degree of histologic dif ferentiation in PLC (P > 0.05). P53 expression was more frequent in la rge than in small tumors (P < 0.05), but had no statistical relation w ith tumor capsule formation, degree of histologic differentiation (P > 0.05). The labelling index pf PCNA and expression of P53 had parallel correlation (P < 0.001). Although the immunohistochemical assessment of PCNA and P53 staining is simple, they were more sensitive than the method of PCR/SSCP and could provide very useful information for the p rognosis and treatment of PLC. The high labelling index of PCNA or ove rexpression of P53 resulted in high tumor recurrence risk, more aggres sive growth and poor survival. Adjuvant therapy should be given to the m postoperatively: transcatheter hepatic arterial chemoembolization af ter hepatectomy may decrease the recurrence rates and improve the surv ival rate of PLC patients.