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Proliferating cell nuclear antigen (PCNA) as a prognostic factor in renal cell carcinoma
L Morell-Quadreny1, F Clar-Blanch, B Fenollosa-Enterna
1Department of Pathology, Medical School of Valencia, Spain.
Background:
A retrospective study was performed on patients with renal cell carcinoma to determine whether tumoral proliferating cell nuclear antigen (PCNA) is a predictive factor.
Methods:
We studied immunohisto-chemical PCNA expression with pc10 monoclonal antibody in 109 renal tumor paraffin sections. These tumors were previously classified according to cellular type by Thoenes, Furman's grading and Robson's staging, Moreover, we counted the number of mitoses in 10 high power fields (HPF) and also evaluated the tumoral necrosis percentage. Ten year survival curve of Kaplan and Meier was obtained for 90 patients.
Results:
Nuclear immunostaining for PCNA showed a statistical correlation with Robson's stage, cellular type and nuclear grade. Moreover, the number of positive nuclei was higher in tumors presenting an elevated mitosis count and higher in degree of necrosis. Survival was significantly poorer in patients whose PCNA index was greater than 5%. Nuclear PCNA immunostaining was shown to be an independent prognostic factor in patients with Robson stage I and also in those who had high cytological grading.
Conclusions:
These results show PCNA to be a prognostic marker for RCC.