CLINICOPATHOLOGICAL FEATURES AND PROGNOSIS OF RESECTED HEPATOCELLULARCARCINOMAS OF VARIED SIZES WITH SPECIAL REFERENCE TO PROLIFERATING CELL NUCLEAR ANTIGEN

Background. Proliferating cell nuclear antigen (PCNA) is an intranucle ar protein that is linked closely to the cell cycle. An immunohistoche mical study was performed on the expression of PCNA in various sized h epatocellular carcinomas (HCCs) to determine the relation between the proliferative activity of cancer cells and prognosis. Methods. One hun dred forty-one neoplasms resected from 141 patients who underwent hepa tic surgery for HCC at Kyushu University hospital from April, 1991, to July, 1993, were studied immunohistochemically using monoclonal antib ody for PCNA (PC10), and analyzed for a possible correlation between P CNA labeling index (PCNA-LI) and the prognosis of patients with HCC. R esults. Proliferating cell nuclear antigen reactive cancer cells were observed throughout the HCC. The PCNA-LI ranged from 1.2%-91.6%, with a mean of 37.7%. The high PCNA-LI (>37.7) group showed a significantly higher incidence of tumor thrombus in the portal vein, higher Edmonds on's Grade, and a higher recurrence rate than the low PCNA-LI (<37.7) group. Hepatocellular Carcinomas were divided into three groups accord ing to tumor size. Based on the clinicopathologic findings, in small ( <30 mm) HCCs, the high PCNA-LI (>29.0) group showed a significant high er Edmondson's grade and a higher recurrence rate than the low PCNA-LI (<29.0) group. In medium (30-60 mm) HCCs, the high PCNA-LI (>36.1) gr oup showed a significantly higher recurrence rate than the low PCNA-LI (<36.1) group, although there was no difference in the pathologic fin dings between the high (>59.4) and low (<59.4) PCNA-LI groups. Conclus ions. Proliferating cell nuclear antigen labeling index is closely rel ated to cell differentiation and the prognosis of HCC. Furthermore, PC NA-LI was found to be useful in predicting the intrahepatic spread and prognosis of small (<30 mm) and medium (30-60 mm) but not large (>60 mm) HCCs.