S. Tanaka et al., PROLIFERATING CELL NUCLEAR ANTIGEN EXPRESSION CORRELATES WITH THE METASTATIC POTENTIAL OF SUBMUCOSAL INVASIVE COLORECTAL-CARCINOMA, Oncology, 52(2), 1995, pp. 134-139
To examine the malignant potential of submucosal invasive colorectal c
arcinoma, the relationship between proliferating cell nuclear antigen
(PCNA) expression and clinicopathologic risk factors for lymph node me
tastasis was studied in 149 patients with submucosal invasive colorect
al carcinoma. The depth of submucosal invasion was classified as scant
y or massive. Histologic subclassification at the submucosal deepest i
nvasive portion was done as follows: well differentiated (W), moderate
ly well differentiated (Mw), moderately poorly differentiated (Mp) or
poorly differentiated (For). Tumor growth was divided into polypoid gr
owth and nonpolypoid growth. The PCNA expression (labeling index, LI)
was examined at the submucosal deepest invasive portion. The PCNA-LI o
f tumors showing lymph node metastasis (mean, 56.5 +/- 19.0%) was sign
ificantly higher than that of tumors without lymph node metastasis (me
an, 41.5 +/- 19.3%; p < 0.01). The PCNA-LI of Mp tumors (mean, 57.7 +/
- 16.5%) was significantly higher than that of W (mean, 38.5 +/- 19.0%
; p < 0.05) and Mw (mean, 43.7 +/- 19.1%; p < 0.05) tumors. The PCNA-L
I of tumors without adenomatous features (mean, 47.9 +/- 20.5%) was si
gnificantly higher than that of tumors with such features (mean, 37.1
+/- 17.1%; p < 0.05). The PCNA-LI was not correlated with other risk f
actors for lymph node metastasis, such as lymphatic invasion, depth of
submucosal invasion, macroscopic type, and growth pattern. These resu
lts indicate that the PCNA-LI may be useful marker for predicting the
potential metastases to lymph nodes in submucosal invasive colorectal
carcinoma, while the proliferative activity of cancer cells correlates
with the degree of the differentiation in the area of deepest invasio
n.