Clinical application of proliferating cell nuclear antigen, oncoprotein p53 and tumor front grading analysis in patients operated on for laryngeal cancer

The authors assessed proliferating cell nuclear antigen (PCNA), p-53 oncopr otein and morphologic tumor front grading (TFG) in patients with advanced s quamous cell carcinoma (SCC), of the larynx and a poor prognosis and tried to find a correlation with tumor stage, the Broders grading system, local a nd neck lymph node metastases, as well as nodal and local recurrences. in a ddition, utility of the parameters investigated was evaluated in developing a prognostic factor model, using uni- and multivariate Cox regression anal ysis. included in this study were 54 patients (mean age 57 years +/- 8.6). PCNA-positive staining was found in all but one patient with advanced disea se. while p-53 stained positively in only 24 subjects (44.4%). The PCNA ind ex ranged from 4.6 to 59.0% (mean, 23.4 +/- 11.0) and the p-53 index varied from 4.0 to 42.0% (mean, 17.2 +/- 8.6). The TFG score ranged from 9 to 23 points (mean, 15.1 +/- 3.2). PCNA, p-53 and TFG were found to be the marker s that provided significant additional information about the biological beh avior of tumor cells. The high variability of the results (PCNA, p53) and h igh percentage of negatively stained cells (p-53) reduced their application in clinical use. PCNA correlated with tumor grade, G (r = 0.38; P < 0.01), but negatively with nodal (N) disease(r = -0.37, P < 0.01). The mean value s of PCNA and p-53 index were higher in the subgroup with local recurrences . Our present attempt to develop a useful prognostic factor model failed.