增殖细胞核抗原在膀胱移行细胞癌中的表达及其预后评价

EXPRESSION AND PROGNOSTIC EVALUATION OF PROLIFERATING CELL NUCLEAR ANTIGEN (PCNA) IN TRANSITIONAL CELL CARCINOMA OF THE URINARY BLADDER

目的：探讨增殖细胞核抗原（ｐｒｏｌｉｆｅｒａｔｉｎｇｃｅｌｎｕｃｌｅａｒａｎｔｉｇｅｎ，ＰＣＮＡ）在膀胱移行细胞癌中的表达及其与预后的关系。方法：用抗ＰＣＮＡ的单克隆抗体ＰＣ１０免疫组化染色常规石蜡包埋的膀胱癌组织。结果：全部４８例膀胱癌标本中４６例ＰＣＮＡ显示阳性（９５８％），正常膀胱组织均为阴性。ＰＣＮＡ指数在Ⅰ、Ⅱ、Ⅲ级肿瘤中分别为（８２８±８６８）％，（２３８２±１６０２）％，（４４６８±２４６５）％。在Ｔａ～Ｔ１和Ｔ２～Ｔ４期肿瘤中分别为（１２５８±１２３３）％和（３４５５±２１８９）％。ＰＣＮＡ指数在各病理分级和分期间均有统计意义（Ｐ＜０．０１）。为了比较ＰＣＮＡ指数与生存率，根据ＰＣＮＡ染色平均水平，将患者分为两组即高ＰＣＮＡ组，其ＰＣＮＡ指数＞２１％和低ＰＣＮＡ组，其ＰＣＮＡ指数＜２１％。我们用Ｌｏｇｒａｎｋ方法对生存率统计发现高ＰＣＮＡ组的预后明显比低ＰＣＮＡ组的预后差（Ｐ＜０．０１）。结论：ＰＣＮＡ表达与膀胱癌病理分级、临床分期和预后均有密切关系，可作为膀胱癌一个有效的预后指标。

Objective:To investigate expression of proliferating cell nuclear antigen (PCNA) in transitional cell carcinoma (TCC) of the urinary bladder and its relation to prognosis Methods:Anti-PCNA monoclonal antibody PC10 was used to stain PCNA in routine paraffin-embedded sections from TCC. Results:Positive staining was found in 95.8% of bladder cancer (46/48), but in none of normal tissues. The mean PCNA labelling index(LI) were (8.288.68)% in pathologic grade ,(23.8213.02)% in and (44.6824.65)% in , while the values were (12.5812.33)% and (34.5521.89)% in clinical stages TaT1 and T2T4 respectively. There were statistically significant differences in PCNA LI between tumours of different grads and stages( P <0.01).To compare PCNA index and survival, patients were divided into two groups depending on the median level of PCNA staining: the high PCNA group, for which the PCNA LI was greater than 21%, and the low PCNA group, for which the index was less than 21%. The survival rate was calculated using the Log . We found the prognosis of the high PCNA group to be significantly worse than that of the low PCNA group( P <0.01). Conclusion: The expression of PCNA showed colse relation with histopathologic grade, clinical stage and prognosis in TCC, can be suggested to be effective as a prognostic indicator in TCC.