PROLIFERATING CELL NUCLEAR ANTIGEN (PCNA) IN PANCREATIC ADENOCARCINOMA

Interpretation of pancreatic biopsy material can pose substantial diff iculties, particularly in the presence of chronic pancreatitis where d uctular changes and fibrosis may mimic adenocarcinoma. We examined whe ther differences in cell kinetics could aid in the distinction between pancreatic carcinoma and chronic pancreatitis. Pancreatic tissue was obtained by percutaneous ultrasonographic guided biopsy. There were a total of thirty-four cases comprising patients with chronic pancreatit is (N = 11) and those with adenocarcinoma (N = 23). The cell cycle act ivity was determined in sections of routinely paraffin-processed, form alin-fixed biopsy material using immunohistochemical stains for the mo noclonal proliferating cell nuclear antigen antibody PCNA (PC 10), a 3 6 kd nuclear protein synthesized in the late G1 and S phase. After cal culating the PCNA index (% of positively staining nuclei compared to t otal number of nuclei counted) these were compared in the conditions s tudied. The PCNA indices in chronic pancreatitis were low with a mean of 5%, while those of adenocarcinoma were 53% (p < 0.001). In conclusi on, the PCNA index in pancreatic adenocarcinoma is significantly highe r than in chronic pancreatitis. Determination of the PCNA index may be helpful as an adjunct in the diagnosis of problematic cases.