title: The prognostic significance of proliferating cell nuclear antigen in patients with lymph node-positive breast cancer.
abstract: OBJECTIVE
  To evaluate the prognostic significance of proliferating cell nuclear antigen (PCNA) in patients with lymph node-positive primary breast cancer.
  
  
  METHODS
  A retrospective study.
  
  
  METHODS
  A tertiary care hospital.
  
  
  METHODS
  A consecutive series of 123 patients with lymph node-positive primary breast cancer.
  
  
  METHODS
  The PCNA-labeling index [(PCNA-positive cells/1000 cells) x 100] was quantified in paraffin-embedded tissue specimens from 123 patients with lymph node-positive primary breast cancer by immunohistochemical staining. Other important clinicopathological variables, including estrogen receptor status, histological grade, lymph node status, primary tumor status, ploidy pattern, S-phase fraction, and TNM staging, were also identified and evaluated.
  
  
  METHODS
  The influence of the PCNA-labeling index on the disease-free survival rate and overall survival rate.
  
  
  RESULTS
  The PCNA-labeling index of the tissue specimens tested from 123 patients ranged from 11% to 82%. The PCNA-labeling index was closely related to primary tumor status, histological grade, TNM staging, and S-phase fraction. Between patients with a high PCNA-labeling index (> 35%) and those with a low PCNA-labeling index (< or = 35%), there were significant (P < .01) differences in both 5-year disease-free survival rates (2% vs 85%) and 5-year overall survival rates (2% vs 92%). When the PCNA-labeling index and all the clinicopathologic variables were entered into a multivariate analysis for either disease-free survival or overall survival by the Cox proportional hazards model, the PCNA-labeling index emerged as an independent prognostic factor.
  
  
  CONCLUSIONS
  Based on our results, the PCNA-labeling index potentially is a useful prognostic factor for lymph node-positive primary breast cancer.
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China.
authors.forename: S M
authors.initials: SM
authors.lastname: Sheen-Chen
authors.forename: H L
authors.initials: HL
authors.lastname: Eng
authors.forename: F F
authors.initials: FF
authors.lastname: Chou
authors.forename: W J
authors.initials: WJ
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000097:blood*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D018809:Proliferating Cell Nuclear Antigen