Expression of proliferating cell nuclear antigen in premalignant lesions of the larynx.
OBJECTIVE
This study was performed to 1) evaluate the proliferative activity in premalignancies of the larynx by immunostaining for proliferating cell nuclear antigen (PCNA), 2) to examine the relationship between PCNA expression and histological diagnosis and 3) to evaluate clinical values of PCNA immunostaining.


METHODS
The percentage of PCNA-positive nuclei (PCNA index) and their highest location (PCNA grade) were evaluated in 44 specimens of premalignant lesions, 7 premalignant lesions near carcinomas, 9 normal epithelium, and 12 early invasive carcinomas of the larynx. Follow-up was conducted.


RESULTS
The mean of PCNA indices in premalignancies was significantly higher than in normal epithelium but lower than in early invasive carcinomas. PCNA index had no apparent correlation with the histological diagnosis, but in the same case, the higher degree of dysplasia showed higher PCNA index. PCNA grade showed significant correlation with the histological diagnosis. Cases with higher PCNA expression showed higher percentages of recurrence and cancerization. Premalignant lesions near carcinomas presented significantly high PCNA expression.


CONCLUSIONS
The proliferative activity in premalignancies of the larynx is higher than in normal epithelium and lower than in carcinomas. It differs from case to case, but in the same case the higher degree of dysplasia possesses higher proliferative activity. Dysplasia is associated with abnormal proliferation pattern. Special attention should be paid to those with abnormal proliferation patterns as well as high proliferative activity. PCNA immunostaining is of some referential value in predicting clinical outcome and guiding to make an early diagnosis of malignancy.
Zhao
R
R
Department of Otolaryngology-Head and Neck Surgery, Kurume University, Japan.
Hirano
M
M
Kurita
S
S
D002277:Carcinoma / Q000276:immunology / Q000473:pathology*; D002455:Cell Division; D006801:Humans; D007150:Immunohistochemistry; D007822:Laryngeal Neoplasms / Q000276:immunology / Q000473:pathology*; D007830:Larynx / Q000276:immunology / Q000473:pathology*; D010865:Pilot Projects; D011230:Precancerous Conditions / Q000276:immunology / Q000473:pathology*; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis*
D018809:Proliferating Cell Nuclear Antigen