Prognostic significance of PCNA expression in laryngeal cancer

Objective: To assess the prognostic value of proliferating cell nuclear ant igen (PCNA) in laryngeal carcinoma and its relation with other known progno stic clinicopathologic variables. Design: A retrospective cohort study of 92 patients chosen randomly from pa tients treated between 1964 and 1993 with the diagnosis of laryngeal cancer . Prognostic factors including PCNA expression, grade, lymphovascular invas ion, depth of tumor margins, neck metastasis, and clinical outcome were eva luated. Setting: Hacettepe University Medical Faculty, Ankara, Turkey. Patients: Eighty-five men and 7 women operated on for squamous cell carcino ma of the larynx were studied. Sixty-nine patients had total and 20 patient s had partial laryngectomy with neck dissection, and 3 patients had endolar yngeal tumor excision. Intervention: Hematoxylin and eosin-stained sections were reevaluated for g rade, lymphovascular invasion, and depth of tumor margins; sections stained with monoclonal antibody against PC10 were examined for PCNA expression. Results: The PCNA index correlated with grade, lymphovascular invasion, dep th of tumor margins, neck metastasis, and local-regional recurrence. The PC NA index values of patients with occult metastasis were significantly highe r than those of patients without metastasis (P=.006). Conclusions: The PCNA index is a more sensitive variable than grade in pred icting tumor proliferation, occult lymph node metastasis, and prognosis. Th ese re suits suggest that the PCNA index can be used in decision making for treatment and assessment of prognosis in laryngeal carcinomas.