title: Comparison of rectal mucosal proliferation measured by proliferating cell nuclear antigen (PCNA) immunohistochemistry and whole crypt dissection.
abstract: Rectal mucosal proliferation has been promoted as an intermediate marker for risk of colorectal neoplasia. Proliferating cell nuclear antigen (PCNA) immunohistochemistry has become a standard method to measure cell proliferation. Whole-crypt dissection may provide a technically simpler method for determining proliferation within an entire crypt. We conducted a study to assess the reliability (reproducibility) of whole-crypt dissection in 10 subjects. Reliability of whole-crypt dissection with the subject as the unit of observation was excellent. The intraclass correlation coefficient for subjects was 0.93. Biopsy-to-biopsy reliability was lower (r=0.86) and crypt-to-crypt reliability lower still (r = 0.35). There was poor correlation between measures of proliferation index using the two techniques (Kendall's tau = 0.13; P = 0.08). Compartment analysis based on the percentage of the total number of labeled cells appearing in each crypt quartile also did not demonstrate a significant correlation between the two measures. We conclude that PCNA labeling index and whole-crypt mitotic count are not comparable measures of rectal mucosal proliferation.
authors.affiliation: Department of Medicine, University of North Carolina at Chapel Hill 27599-7080, USA.
authors.forename: S C
authors.initials: SC
authors.lastname: Murray
authors.forename: R S
authors.initials: RS
authors.lastname: Sandler
authors.forename: T O
authors.initials: TO
authors.lastname: Keku
authors.forename: C M
authors.initials: CM
authors.lastname: Lyles
authors.forename: R C
authors.initials: RC
authors.lastname: Millikan
authors.forename: S I
authors.initials: SI
authors.lastname: Bangdiwala
authors.forename: L L
authors.initials: LL
authors.lastname: Kupper
authors.forename: W
authors.initials: W
authors.lastname: Jiang
authors.forename: M H
authors.initials: MH
authors.lastname: Ulshen
mesh_terms: D001706:Biopsy; D002452:Cell Count; D002455:Cell Division; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis*; D012007:Rectum / Q000473:pathology*; D015203:Reproducibility of Results; D012307:Risk Factors
chemical_list: D018809:Proliferating Cell Nuclear Antigen