Cell proliferation of transitional cell bladder tumours determined by PCNA/cyclin immunostaining and its prognostic value.
Cell proliferation of transitional cell bladder cancer (TCC) was determined by PCNA (proliferating cell nuclear antigen)/cyclin immunostaining in 178 TCCs and the results were related to established prognostic factors, progression and survival during a mean follow-up period of 10 years. The fraction of PCNA/cyclin positive nuclei was related to T-category (P = 0.008), papillary status, WHO grade, DNA ploidy, S phase fraction, M/V index (volume corrected mitotic index) and AgNORs (silver stained nucleolar organiser regions) (for all P less than 0.001). TCCs presenting with pelvic lymph node metastasis at diagnosis had a significantly higher growth fraction than the tumours confined to the bladder wall (P less than 0.001). The fraction of PCNA/cyclin positive nuclei predicted progression in T-, N- and M-categories (P less than 0.001). In Ta-T1 tumours high fraction of PCNA/cyclin positive nuclei predicted metastasis (P = 0.019). In survival analysis the fraction of PCNA/cyclin positive nuclei predicted survival in the entire cohort (P less than 0.001) and in Ta-T1 tumours (P = 0.0005). In a multivariate survival analysis the fraction of PCNA/cyclin positive nuclei showed independent predictive value in the entire cohort (P = 0.046), in papillary tumours (P = 0.006) and in Ta-T1 tumours (P = 0.015). The results show that the growth fraction as determined by PCNA/cyclin immunostaining is a significant prognostic variable in TCC.
Lipponen
P K
PK
Department of Pathology, University of Kuopio, Finland.
Eskelinen
M J
MJ
D000704:Analysis of Variance; D000782:Aneuploidy; D000951:Antigens, Neoplasm / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis*; D002295:Carcinoma, Transitional Cell / Q000473:pathology*; D002455:Cell Division; D015331:Cohort Studies; D016213:Cyclins / Q000032:analysis*; D004273:DNA, Neoplasm / Q000032:analysis; D004171:Diploidy; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009687:Nuclear Proteins / Q000032:analysis*; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen; D012189:Retrospective Studies; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000473:pathology*
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D016213:Cyclins; D004273:DNA, Neoplasm; D009687:Nuclear Proteins; D018809:Proliferating Cell Nuclear Antigen