卵巢上皮性囊腺癌PCNA表达及其意义

EXPRESSION OF PROLIFERATING CELL NUCLEAR ANTIGEN IN OVARIAN EPITHELIAL CYSTADENOCARCINOMA

目的探讨增殖细胞核抗原（ＰＣＮＡ）在卵巢癌的表达情况及其与生物学特征、预后间的关系。方法应用标记链亲和素生物素（ＬＳＡＢ）法检测７０例卵巢上皮性囊腺癌的ＰＣＮＡ表达，另选６例良性囊腺瘤作对照。结果ＰＣＮＡ强阳性４５例，弱阳性２５例。强、弱两组中，临床Ⅲ～Ⅳ级分别为２９／４５例和４／２５例（Ｐ＜０．０１）；癌肿腹腔播散分别为３５／４５例和６／２５例（Ｐ＜０．００１）；出现腹水分别为２６／４５例和８／２５例（Ｐ＜０．０５）；病理组织学类型和分化程度上，交界性低度恶性上皮性肿瘤和囊腺癌Ⅰ级，分别为４／４５例和２２／２５例，囊腺癌Ⅱ～Ⅲ级分别为４１／４５例和３／２５例（Ｐ＜０．０１）。强、弱两组生存满５年者分别占８．３％（２／２４）和８７．５％（１４／１６）（Ｐ＜０．０１）。结论卵巢上皮性囊腺癌ＰＣＮＡ阳性表达越强、临床期别增大、肿瘤分化程度降低，浸润转移倾向越明显，预后则越差。提示ＰＣＮＡ可反映肿瘤的生长特性，是指导肿瘤诊治、评估预后的有用指标。

PURPOSE Proliferating cell nuclear antigen (PCNA) can have an increased expression in various malignant tumors.We have analysed the relation between the prognosis,the characteristics of biological behavior and the expression of PCNA in ovarian cancer. METHODS PCNA expression has been measured in 70 cases of ovarian cystadenocarcinoma by LSAB immunohistochemical methods.45 cases had intensive expression of PCNA and 25 cases had weak expression.Comparing the two groups,we found that the clinical stage Ⅲ～Ⅳ in these cases were 29/45 (χ 2=15 77, P <0 01),while intraabdominal metastasis were 35/45 and 6/25 (χ 2=19 15, P <0 001),and ascites were 26/45 and 8/25 (χ 2=4 28, P <0 05) respectively.Cases of survival after 5 year follow up in the two groups were 2/24 and 14/16 (χ 2=25 07, P <0 001) respectively. CONCLUSIONS Cases with more intensive expression of PCNA were also in the later clinical stages,lower differentiation,marked tendency to infiltration and metastasis,and poorer prognosis.Therefore,expression of PCNA as representing proliferating cells,can fully demonstrate the characteristics of cell growth and may be a useful indicator for tumor diagnosis and prognosis assessment.