The prognostic value of proliferating cell nuclear antigen, Ki-67 and nucleolar organizer region in transitional cell carcinoma of the bladder.
OBJECTIVE
To investigate the value of proliferating cell nuclear antigen (PCNA), Ki-67 antigen labelling indices and nucleolar organizer region (NOR) score in relation to histological grade, stage, recurrence and progression of the bladder tumor.


METHODS
Tissue specimens from 77 bladder cancer patients (43 superficial, 34 invasive) were immunostained with PCNA and Ki-67 and stained with AgNOR. Thirteen specimens of normal bladder mucosa served as controls.


RESULTS
In comparison to normal bladder mucosa the values of the three indicators were significantly greater (p < 0.001). There was a significant relationship between PCNA, Ki-67 indices, AgNOR scores and grade and stage of the tumor (p < 0.001). All indicators also correlated with each other (p < 0.001). The Kaplan-Meier curves for recurrence-progression free survival revealed that patients with a PCNA labelling index >36.22%, Ki-67 labelling index >29.68% and AgNOR score > 3.34 had a worse prognosis than those with <36.22%, <29.68% and <3.34, respectively.


CONCLUSIONS
PCNA, Ki-67 indices and AgNOR scores correlated with each other and with tumor grade and stage. These proliferation markers may give objective and accurate information about the biological behavior of bladder transitional cell carcinoma.
Bozlu
Murat
M
Medical Faculty of Mersin University, Department of Urology, Turkey. mbozlu@hotmail.com
Orhan
Diclehan
D
Baltaci
Sümer
S
Yaman
Onder
O
Elhan
Atilla Halil
AH
Tulunay
Ozden
O
Müftüoğlu
Yusuf Ziya
YZ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000032:analysis*; D002295:Carcinoma, Transitional Cell / Q000276:immunology* / Q000473:pathology*; D016022:Case-Control Studies; D046508:Culture Techniques; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009697:Nucleolus Organizer Region / Q000276:immunology*; D011336:Probability; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis*; D012016:Reference Values; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D001749:Urinary Bladder Neoplasms / Q000276:immunology* / Q000473:pathology*
D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D018809:Proliferating Cell Nuclear Antigen