title: Expression and prognostic significance of proliferating cell nuclear antigen and Ki-67 in malignant ovarian germ cell tumors.
abstract: BACKGROUND
  Both proliferating cell nuclear antigen (PCNA) and Ki-67 are proliferative markers known to correlate with the cell proliferative state. The aim of this study was to evaluate the usefulness of PCNA and Ki-67 immunoreactivity in the assessment of clinicopathologic features and prognosis in patients with malignant ovarian germ cell tumors.
  
  
  METHODS
  Thirty-one patients with surgically resected malignant ovarian germ cell tumors were investigated. The clinicopathologic features and survival data of these patients were recorded. Immunohistochemical staining with monoclonal antibodies (PC 10 for PCNA, and MIB-1 for Ki-67) were performed on paraffin embedded tissue from each patient. The correlation of the immunoreactivity of these two markers with the clinicopathologic features and prognosis were studied.
  
  
  RESULTS
  All of the tumors were positive for PCNA and Ki-67, but the intensity of expression varied widely. The immunoreactivity in each tumor was also heterogeneous. The scoring of PCNA and Ki-67 was determined by a semiquantitative method. Both advanced tumor stage (stages III and IV) and high PCNA score (scores 3 and 4) indicated a poorer prognosis for survival than did early stage (stages I and II) and a low PCNA score (scores 1 and 2) (p = 0.017 and p = 0.008, respectively). In addition, the proportion of tumor relapse and tumor-induced death was more accurately predicted by PCNA and Ki-67 scoring than by tumor staging (chi 2 = 0.3159, chi 2 = 0.7186 and chi 2 = 1.9689, respectively).
  
  
  CONCLUSIONS
  PCNA and Ki-67 proliferative markers appear promising to differentiate patients into low- and high-risk groups. In the presence of a high PCNA or Ki-67 score, aggressive postoperative chemotherapy is warranted, even if the disease is in a very early stage.
authors.affiliation: Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taiwan, ROC.
authors.forename: F S
authors.initials: FS
authors.lastname: Liu
authors.forename: J T
authors.initials: JT
authors.lastname: Chen
authors.forename: S C
authors.initials: SC
authors.lastname: Liu
authors.forename: A
authors.initials: A
authors.lastname: Shih
authors.forename: R T
authors.initials: RT
authors.lastname: Shih
authors.forename: E S
authors.initials: ES
authors.lastname: Ho
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D018237:Germinoma / Q000401:mortality*; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D019394:Ki-67 Antigen / Q000032:analysis*; D010051:Ovarian Neoplasms / Q000401:mortality*; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis*
chemical_list: D019394:Ki-67 Antigen; D018809:Proliferating Cell Nuclear Antigen