TUMOR ANGIOGENESIS AND TUMOR-CELL PROLIFERATION AS PROGNOSTIC INDICATORS IN GASTRIC-CARCINOMA

Tumour growth depends on neovascularisation and tumour cell proliferat ion. Factor VIII-related antigen (F-VIII RA) localises to vascular end othelium. Expression of proliferating cell nuclear antigen (PCNA) is c orrelated with cell proliferation. We investigated the correlation bet ween the expression of these antigens and prognosis in gastric carcino ma. A total of 108 specimens resected from patients with gastric carci noma were investigated by staining with monoclonal antibodies against F-VIII RA and PCNA. Microvessel count (MVC; the mean number of microve ssels in the five areas of highest vascular density at 200 x magnifica tion) and PCNA labelling index (PCNA LI; percentage of positive cells in more than 500 tumour cells) were determined. The results showed tha t prognosis was significantly worse in patients who had a tumour with a high MVC (16 or greater) or a high PCNA LI (42% or greater) than in those patients who had a tumour with a low MVC (less than 16) or a low PCNA LI (less than 42%). Furthermore, MVC was significantly associate d with the risk of hepatic recurrence. In conclusion, both MVC and PCN A LI may be good prognostic indicators in patients with gastric carcin oma.