PREDICTION OF THE PROGNOSIS OF PATIENTS WITH GASTRIC-CANCER BY ERBB-2TISSUE STATUS AND EXPRESSION OF PROLIFERATING CELL NUCLEAR ANTIGEN

Correlation between erbB-2 tissue status and expression of proliferati ng cell nuclear antigen (PCNA) was studied in 164 gastric carcinomas, and these results were compared with the risk of metastasis and progno sis. Thirty-one (19%) tumors showe evidence of erbB-2 protein expressi on, and the PCNA index ranged from 8.2% to 77.2% (mean; 40%). erbB-2 p rotein positive tumors were most often encountered in the following cl inicopathological groups: tumors with serosal invasion, lymph node met astasis, and venous invasion. There was a significant correlation betw een PCNA index and lymph node metastasis. In addition, erbB-2 positive tumors showed significantly higher PCNA index than erbB-2 negative tu mors. Cox prortional hazard model identified lymph node metastasis. In invasion, liver metastasis, and erbB-2 tissue status as independent p rognostic factors, but PCNA index was not an independent prognostic fa ctor. However, by combining erbB-2 tissue status and PCNA index, PCNA index. was a good prognostic factor particularly in patients with erbB -2 negative tumors. These results indicate that the determination of e rbB-2 tissue status, when combined with PCNA index, may be useful in t he prediction of the prognosis and in deciding the therapeutic schedul e of patients with gastric cancer.