PROGNOSTIC-SIGNIFICANCE OF PROLIFERATING CELL NUCLEAR ANTIGEN EXPRESSION IN TRANSITIONAL-CELL CARCINOMA OF THE UPPER URINARY-TRACT

Background: Haphazard cell proliferation is a fundamental biologic def ect in cancer. Thus, assessment of the growth fraction provides a valu able index of biological property for human neoplasm. Proliferating ce ll nuclear antigen (PCNA) expression has been used to estimate the gro wth fraction of human cancer, and its prognostic value. Information in transitional cell carcinoma (TCC) of the upper urinary tract, however , is very few. Materials and Methods: A total of 73 patients with TCC of the upper urinary tract was collected between July 1988 and Decembe r 1995 for this study. The labeling index of PCNA immunostaining was c orrelated with clinicopathologic factors and compared for its prognost ic value with a median follow-up of 54 months. Results: The PCNA index was positively associated with histological grading, tumor stage and patient prognosis (P=0.00, respectively). Multivariate analysis demons trated that significant factors in relation to patient survival were t umor stage (P=0.01), followed by PCNA index (P=0.04) and gender of pat ients (P=0.04). Multiple comparison revealed that PCNA index set at 0. 30 had prognostic value in terms of patient survival (P=0.00), and the risk of metachronous bladder recurrence (P=0.02). Conclusion: Our dat a suggested that assessment of PCNA index may be used as an adjuvant p rognostic factor for patients with TCC of the upper urinary tract.