Proliferating cell nuclear antigen in endometrial adenocarcinomas of endometrioid type correlated with histologic grade, stage, previous hormonal treatment, and survival

p53 Protein and Proliferating Cell Nuclear Antigen (PCNA) Expression in Small Round Cell Tumors of Bone and Adjacent Soft Tissue

Sixty small cell tumors of bone and adjacent soft tissue were studied in an attempt to define the incidence of immunohistochemically detectable p53 protein and cor relate these findings with the results of proliferating cell nuclear antigen (PCNA) immunohistochemical staining and mitotic counts. All of the lesions had been for malin-fixed and paraffin-embedded; half were subjected to decalcification prior to processing. The study population included 12 Ewing's sarcomas of bone, 3 atypical Ewing's sarcomas of bone, 3 primitive neuroectodermal tumors of bone, 11 Askin tumors of the thoracopulmonary region, 11 small cell osteosarcomas of bone, 10 mesenchymal chondrosarcomas of bone, and 10 malignant lymphomas involving bone. The patients ranged in age at the time of presentation from 17 to 67 years. Overall, the incidence of p53 positivity was extremely low in these lesions, irre spective of tumor type. Positive nuclear staining with an antibody to p53 was found in none of the 12 Ewing's sarcomas, none of the 3 atypical Ewing's sarcomas, none of the 3 primitive neuroectodermal tumors of bone, 1 of the 11 Askin tumors of the thoracopulmonary region (1.5% of tumor cells positive), 1 of the 11 small cell osteosarcomas (2% of tumor cells positive), 1 of the 10 mesenchymal chondrosar comas of bone (7% of tumor cells positive), and 2 of the 10 malignant lymphomas involving bone (0.5% and 1% of tumor cells positive, respectively). The majority of tumors showed PCNA positivity within the tumor cells, although the incidence of PCNA positivity within the histologic types varied greatly; in general, the higher PCNA counts corresponded to higher mitotic counts within the individual lesions. The present study did not demonstrate any correlation between mutant p53 accu mulation detected by immunohistochemistry and tumor type, and so it is unlikely that p53 positivity will prove to be of great use in the differential diagnosis of these lesions. A correlation between p53 positivity and PCNA staining or mitotic activity was not apparent. Int J Surg Pathol 2(4):259-268, 1995

A comparative study of nucleolar organizer region, proliferating cell nuclear antigen and epidermal growth factor receptor staining in colon tumours

Several studies have reported that proliferating cell nuclear antigen (PCNA), nucleolar organizer regions (NOR) and epidermal growth factor receptor (EGF-R) are cellular proliferation parameters in malignant tumours. However, the correlation of EGF-R with PCNA and NOR has not been reported in colon tumours. To clarify this, we investigated the correlation of the expression of EGF-R with PCNA and NOR in colonic epithelial tumours. Using immunohistochemical staining and one-step silver staining techniques, the expressions of EGF-R-, PCNA- and NOR-associated protein were studied in paraffin sections from five normal mucosae, 10 adenomas with mild atypia, 16 adenomas with moderate atypia, 32 adenomas with severe atypia including carcinoma in situ and 47 with invasive colon carcinomas. Significant differences were found among the respective degrees of atypia in Ag-NOR counts, PCNA labelling index (LI), and the expression of EGF-R. However, there were no significant differences among the Ag-NOR counts of the severe atypia and invasive carcinoma. There was a significant positive correlation between Ag-NOR counts and PCNA LI (P < 0.001). The Ag-NOR counts and PCNA LI in EGF-R-positive cases were higher than in EGF-R-negative cases (P < 0.001). These results indicate that each of the parameters increased significantly with the increase in atypia and the progression of cancer. Epidermal growth factor receptor provokes an exacerbation of protein synthesis and the cell cycle in colonic epithelial tumours.

Assessment of proliferating cell nuclear antigen expression and prognosis in patients with renal cell carcinoma with pulmonary metastases

BACKGROUND

The presence of proliferating cell nuclear antigen (PCNA) has been suggested as a more important prognostic marker than either grade or mitotic index in the prognosis of patients with renal cell carcinoma. We assessed the immunoreactivity of PCNA in primary lesions and pulmonary metastases from patients with renal cell carcinoma and correlated the results with various histopathologic features and prognostic factors.

METHODS

We studied the relationship between PCNA expression and clinical prognostic factors from resected primary lesions and pulmonary metastases from 10 patients and primary lesions from 32 patients with renal cell carcinoma without metastases. The cells were immunohistochemically stained with PCNA monoclonal antibody (PC-10) and 1000 nuclei were counted. The results were expressed as a ratio of stained to total cells (PCNA labeling index, LI %).

RESULTS

The PCNA LI of pulmonary metastatic nuclei was significantly higher than the PCNA LI of renal lesions either from patients with (P < 0.05) or without (P < 0.01) metastases. Also, the mean PCNA LI of the pulmonary lesions in patients dying within 3 years of diagnosis was higher than the mean PCNA LI of patients surviving greater than 3 years.

CONCLUSION

Our findings suggest that the PCNA LI, which was determined by immunohistochemical analysis, is an important marker reflecting the biologic behavior of renal cell carcinomas. The degree of PCNA expression in this study was of prognostic significance.

The combination of p53 and age predict cancer specific death in advanced stage (FIGO Ic-IV) of endometrial carcinoma of endometrioid type. An immunohistochemical examination of growth fraction: Ki-67, MIB-1 and PC10; suppressor oncogene protein: p53; oncogene protein: p185 and age, hormone treatment, stage, and histologic grade

OBJECTIVE

Early surgical stage (FIGO Ia + b) is an excellent predictor of survival in endometrial carcinoma of endometrioid type (EC), in contrast to advanced stage which only predict cancer specific death (CSD) in approximately 20-30% of the patients. The value of growth fraction, p53 and p185 as predictor of CSD in EC was studied.

STUDY DESIGN

One hundred and eleven patients (45% hormone-users) with EC were entered prospectively and consecutively into an immunohistochemical study of growth fraction (Ki-67, MIB-1 and PC10), suppressor oncogene protein (p53) and oncogene protein (p185).

RESULTS

All markers except p185 intercorrelated significantly, although weakly, however, marked differences were found in median values of the markers of growth fraction (GF). It was shown that immunohistochemical demonstration of p53 and p185 proteins and stage correlates independently with CSD in EC.

CONCLUSION

The study indicates that the markers of GF do not give exact information about the proliferative compartment of the EC, and it is shown that p53 correlate to CSD, while stage indicate crude death.

Age and race as prognostic factors in endometrial carcinoma

This research was undertaken to evaluate the effects of age and race on prognosis of patients with endometrial carcinoma. A total of 279 patients with endometrial carcinoma treated at State University of New York-Health Science Center and Kings County Hospital Brooklyn, New York from 1975 to 1990 were retrospectively analyzed. Patients were arbitrarily divided into young and old groups (< or = 60 years or > 60 years old, respectively). The distribution of grade, clinical stage, and extent of myometrial invasion by age was determined for the entire group and for black and white patients, respectively. Young and old patients were stratified by clinical stage, grade, and extent of myometrial invasion. The corrected median survival of young and old patients by race was evaluated by Kaplan Meier's method of analysis. Older patients in general had higher clinical stage, higher grade, and greater depth of myometrial invasion than younger patients. Also, black patients had higher clinical stage, higher grade, and greater depth of myometrial invasion than white patients. Older black patients had the least favorable distribution of prognostic factors. Overall younger patients had a median survival of 200 months compared to 90 months for older patients (p = 0.0085). The overall corrected median survival for whites was 232 months compared to 108 months for blacks (p = 0.0001). The median survival of older black patients was worst at 40 months, compared to 155 months for older white patients (p = 0.0005). Age is a very important prognostic factor in endometrial carcinoma for both blacks and whites, and it appears to be more pronounced in older black patients.

Nucleolar organizer regions as markers of endometrial proliferation: a study of normal, hyperplastic, and neoplastic tissue

Nucleolar organizer regions (NORs) are loops of DNA that transcribe to ribosomal RNA. They can be visualized as intranuclear black dots by histochemical staining with a colloid silver solution. We applied this method to 78 sections of endometrial tissue obtained either from curettage or from hysterectomy specimens. The histological diagnoses were as follows: normal proliferative (N = 9) or secretory (N = 5) endometrium, simple hyperplasia (N = 10), complex hyperplasia (N = 18), atypical hyperplasia (N = 8), and adenocarcinoma (N = 28). Mean silver-stained NOR (AgNOR) counts per cell were 3.2 (standard error of the mean [SEM], 0.2) in normal proliferative and 2.7 (SEM, 0.2) in normal secretory epithelium, and increased to 4.1 (SEM, 0.3) in simple hyperplasia, to 5.4 (SEM, 0.4) in complex hyperplasia, to 8.1 (SEM, 0.7) in atypical hyperplasia, and finally to 10.0 (SEM, 0.5) in endometrial carcinoma. The differences were significant (one-factor analysis of variance [ANOVA], P < .001). A slight increase but no significant difference was seen between the mean AgNOR counts in endometrial carcinomas of different histological grades. Our study suggests that AgNOR counts are reliable markers of endometrial proliferation and allow a clear distinction between benign, premalignant, and malignant epithelial changes. Our AgNOR findings in endometrial hyperplasia support the concept of various degrees of hyperplasia that can be differentiated on morphological grounds.

Proliferating cell nuclear antigen but not p53 or human papillomavirus DNA correlates with advanced clinical stage in renal cell carcinoma

In this study we investigated 56 renal cell carcinomas immunohistochemically for the expression of proliferating cell nuclear antigen (PCNA) and tumour suppressor protein p53. We also analyzed for the presence of human papilloma virus (HPV) DNA subtypes 6, 11, 16, 18, 31 and 33 by in situ hybridization. In carcinomas which showed more than 10% of PCNA positive nuclei there were significantly more cases with invasion (P = 0.032) or metastatic disease (P = 0.047). Nine out of 22 grade III-IV tumours (40.9%) but only six out of 30 grade I-II tumours (20%) showed more than 10% of PCNA positive cells (P = 0.097). Patients with 10% or more PCNA positive cells in kidney tumours had more advanced disease at the time of diagnosis than those showing less PCNA positive cells (P = 0.05). Six p53 positive cases were found among 56 tumours (11%), but only one case had more than 10% positive cell nuclei. The presence of HPV DNA was found in 29 out of 56 cases (52%). Multiple subtypes were found in 19 cases (34%). The most commonly occurring subtypes were 18 and 33. There was no association between PCNA, p53 and the presence of HPV DNA subtypes. Because of the association of PCNA with invasion and metastatic disease, it would be worth while to study PCNA further as a possible marker for aggressiveness of renal carcinomas. Both this study and those concentrated on mutational analysis suggest that p53 is generally not important for the development of renal cell carcinoma. On the other hand, the presence of HPV DNA in these tumours implicates HPV viral infection in the aetiology of renal cancer.