title: Prognostic significance of proliferating cell nuclear antigen expression in transitional cell carcinoma of the upper urinary tract.
abstract: BACKGROUND
  Haphazard cell proliferation is a fundamental biologic defect in cancer. Thus, assessment of the growth fraction provides a valuable index of biological property for human neoplasm. Proliferating cell nuclear antigen (PCNA) expression has been used to estimate the growth fraction of human cancer, and its prognostic value. Information in transitional cell carcinoma (TCC) of the upper urinary tract, however, is very few.
  
  
  METHODS
  A total of 73 patients with TCC of the upper urinary tract was collected between July 1988 and December 1995 for this study. The labeling index of PCNA immunostaining was correlated with clinicopathologic factors and compared for its prognostic 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 demonstrated that significant factors in relation to patient survival were tumor stage (P = 0.01), followed by PCNA index (P = 0.04) and gender of patients (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).
  
  
  CONCLUSIONS
  Our data suggested that assessment of PCNA index may be used as an adjuvant prognostic factor for patients with TCC of the upper urinary tract.
authors.affiliation: Department of Urology, Medical College, National Cheng Kung University, Tainan, Taiwan, Republic of China.
authors.forename: H L
authors.initials: HL
authors.lastname: Cheng
authors.forename: N H
authors.initials: NH
authors.lastname: Chow
authors.forename: T S
authors.initials: TS
authors.lastname: Tzai
authors.forename: Y C
authors.initials: YC
authors.lastname: Tong
authors.forename: J S
authors.initials: JS
authors.lastname: Lin
authors.forename: S H
authors.initials: SH
authors.lastname: Chan
authors.forename: W H
authors.initials: WH
authors.lastname: Yang
authors.forename: C C
authors.initials: CC
authors.lastname: Chang
authors.forename: Y M
authors.initials: YM
authors.lastname: Lin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism*; D012737:Sex Factors; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000378:metabolism* / Q000473:pathology; D014571:Urologic Neoplasms / Q000378:metabolism* / Q000473:pathology
chemical_list: D018809:Proliferating Cell Nuclear Antigen