PROGNOSTIC IMPLICATIONS OF PROLIFERATING CELL NUCLEAR ANTIGEN (PCNA),AGNORS AND P53 IN NON-HODGKINS-LYMPHOMAS

We investigated the prognostic value of proliferating cell nuclear ant igen (PCNA) and p53 oncoprotein expression and of nucleolar organiser region (NOR) scoring, in relation to classic clinicopathological param eters, in a series of non-Hodgkin's lymphomas (NHL). Paraffin embedded tissue from 91 patients with NHL was stained immunohistochemically wi th the monoclonal antibodies PC-10 (PCNA) and DO-1 (p53) and histochem ically with the AgNOR technique. The median follow-up was 48 (4 to 193 ) months. The impact of PCNA and p53 expression and of AgNOR number on survival was tested using univariate as well as multivariate analysis ,in order to circumvent the heterogeneity in histologic grade, type an d therapy. Univariate analysis identified seven variables related to o verall survival: histologic type and grade, clinical stage, chemothera py, p53 labelling index (LI), PCNA LI and AgNOR score, whereas only on e parameter i.e. histologic grade influenced disease-free survival. In multivariate analysis stage, PCNA LI and AgNOR score predicted indepe ndently overall survival. PCNA was also the only independent predictor of post-relapse survival and histologic grade the most important indi cator of disease-free survival. In conclusion, PCNA expression and AgN OR number may be better predictors of overall and post-relapse surviva l than histologic grade. The latter remains the most valuable prognost ic indicator of disease-free survival.