PROLIFERATING CELL NUCLEAR ANTIGEN (PCNA) IN CEREBRAL CAVERNOMAS - ANIMMUNOCYTOCHEMICAL STUDY OF 42 CASES

BACKGROUND The natural history and growth mechanisms of cerebral caver nous angiomas are unclear, which makes them difficult to manage. We at tempted to evaluate the evolutive potential of cavernomas by studying the proliferative capacity of cells. METHODS We studied 42 histologica lly verified cavernomas with monoclonal antibody to proliferating cell nuclear antigen (PCNA), an accessory protein of the cell cycle, the r ate of which is increased in proliferative cells. The PCNA Labeling In dex (PCNA LI) was calculated in each case, and the results were compar ed with histologic findings (lacy areas, thick walls, thrombi, hemosid erin) and clinical features (epilepsy, hematomas, pseudotumorous signs ). RESULTS Thirty-six of 42 cases (85.7%) revealed stained cells. PCNA LI ranged from 1 to 48% (mean: 23.39%). Statistical analyses showed a positive correlation between PCNA LI and the extent of lacy areas (p < 0.05). On the contrary, collagenous-walled and thrombotic areas rare ly showed positively stained cells. We found no relationship between P CNA LI and clinical features. CONCLUSIONS A proliferative capacity of endothelial cells does exist in some areas of cavernomas and may expla in, besides thromboses and hemhorrages, the growth and even de novo ap pearance of these lesions. Occurrence of fragile blood cavities, thick ening of others, and changes in blood flow may influence the evolution of lesions, Our results suggest that in cavernomas, some areas may un dergo specific changes, which makes them more dynamic lesions than pre viously thought. (C) 1997 by Elsevier Science Inc.