NUCLEAR-DNA CONTENT, PROLIFERATING-CELL NUCLEAR ANTIGEN (PCNA) AND P53 IMMUNOSTAINING IN PREDICTING PROGRESSION OF LARYNGEAL-CANCER IN-SITULESIONS

Squamous epithelial cancer in situ (CIS) of the upper aerodigastric tr act is a histopathologically well-defined condition. However, in clini cal practice, morphological grading of dysplasia is difficult and show s large variability. The biology of CIS remains enigmatic, and there i s yet no reliable way to predict whether a CIS lesion will progress to invasive cancer, remain stable or regress. In the search for markers able to foretell clinical outcome, we performed image DNA cytometry (I CM) and immunohistochemical staining for PCNA as well as p53 in 38 lar yngeal CIS lesions, of which 9 progressed to invasive cancer. The majo rity of the CIS lesions displayed high-grade DNA aberration, a high PC NA-positive rate, and every third lesion was p53-positive by immunosta ining. The lesions which progressed to invasive cancer showed a clear tendency towards more pronounced DNA aberration, a higher percentage o f intense PCNA staining and more frequent p53 positivity. By combining the results from the analyses of DNA, PCNA and p53 in a prognostic in dex for each individual case, we correctly classified 82% of the lesio ns as progressors or non-progressors. (C) 1994 Wiley-Liss, Inc.