title: The assessment of proliferating cell nuclear antigen immunostaining in myelodysplastic syndromes and its prognostic significance.
abstract: Several prognostic factors for patients with myelodysplastic syndromes (MDS) have been identified in previous years. In order to determine prognostic factors characterizing haematopoietic cell kinetics, bone marrow proliferative activity and serum TNF-a levels were measured in 51 cases of MDS. Cell proliferation was evaluated by employing a monoclonal antibody directed against the proliferating cell nuclear antigen (PCNA). The PCNA proliferating index (PCNA PI) and serum TNF-a levels showed significant differences between patients with MDS and normal controls (p<0.0001). PCNA PI and serum TNF-a were significantly higher in the high risk for leukemic transformation FAB subgroups (RAEB, RAEB-t and CMML) in comparison to the low risk group (RA and RARS) (p<0.001). PCNA PI and TNF-a also increased with increasing IPSS score (p<0.05). A positive correlation was noted between TNF-a concentrations and PCNA PI (r:0.36, p<0.008). Univariate analysis using the log-rank test showed that a higher PCNA PI was associated with a significantly shorter survival (p<0.001). We conclude that elevated PCNA PI and TNF-a serum levels are increased in high risk myelodysplastic disease and that a high PCNA PI is predictive of a shorter survival in this group of patients.
authors.affiliation: Department of Hematology, University Hospital of Heraklion, P.O BOX 1352 Heraklion, Crete, Greece. freda@med.uoc.gr
authors.forename: M G
authors.initials: MG
authors.lastname: Alexandrakis
authors.forename: F H
authors.initials: FH
authors.lastname: Passam
authors.forename: K
authors.initials: K
authors.lastname: Dambaki
authors.forename: A M
authors.initials: AM
authors.lastname: Passam
authors.forename: F
authors.initials: F
authors.lastname: Nalbanti
authors.forename: E S
authors.initials: ES
authors.lastname: Stathopoulos
authors.forename: D S
authors.initials: DS
authors.lastname: Kyriakou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001854:Bone Marrow Cells / Q000378:metabolism / Q000473:pathology; D049109:Cell Proliferation; D005260:Female; D006412:Hematopoietic Stem Cells / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis* / Q000378:metabolism; D011446:Prospective Studies; D013194:Staining and Labeling; D016019:Survival Analysis; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D018809:Proliferating Cell Nuclear Antigen; D014409:Tumor Necrosis Factor-alpha