PROGNOSTIC VALUE OF PROLIFERATING CELL NUCLEAR ANTIGEN AND C-ERBB-2 COMPARED WITH CONVENTIONAL HISTOPATHOLOGICAL FACTORS IN BREAST-CANCER

Expression of proliferating cell nuclear antigen (PCNA) and c-erbB-2 o ncoprotein has been assessed in 471 women with breast cancer to evalua te their prognostic value as compared to conventional histopathologica l factors. In univariate analysis, high PCNA expression (greater than or equal to 20%) predicted a significantly worse survival in lymph-nod e-negative tumors (univariate P = 0.031). However, the effect disappea red in multivariate analysis and the histological grade remained the o nly independent factor for this group. Despite its close correlation t o histological grade (P <0.001), PCNA expression discriminated subsets with different survival within the heterogeneous group of moderately differentiated tumors (univariate P = 0.073, multivariate P = 0.075). PCNA expression was not found to be a significant prognostic factor in lymph-node-positive tumors, thus it was of limited value for breast c ancer patients as a whole. c-erbB-2 protein overexpression was associa ted with a worse survival (univariate P = 0.019, multivariate P = 0.05 7) for the entire group of patients. The effect was mainly attributed to the significance of c-erbB-2 as an independent factor in lymph-node -positive (up to three nodes, multivariate P = 0.04; four or more node s: multivariate P = 0.017) and large tumors (>2 cm: multivariate P = 0 .002). c-erbB-2 was without significance in lymphnode-negative patient s. Though both factors might amplify the prognostic information for di stinct patient subsets they do not achieve the strong prognostic value of conventional histopathological features in breast cancer.