Expression of proliferating cell nuclear antigen and deoxyribonucleic acid value in renal cell carcinoma: correlation with different histopathological parameters and patient survival.

Abstract

Forty-six human renal cell carcinoma tissues obtained from radical nephrectomy, fixed in 10% formaldehyde solution and embedded in paraffin for histopathological examination were used for immunohistochemical staining of proliferating cell nuclear antigen (PCNA) using a monoclonal antibody PC10, and 37 of the 46 were also used for flow cytometric DNA ploidy analysis. PCNA-positive rates were compared with different histopathological parameters and patient survival. The relationships between the DNA ploidy and PCNA-positive rates and patient survival were also determined. Statistically significant differences in PCNA-positive rates were observed in different histopathological grades and stages of renal cell carcinoma. No relationship was observed between the PCNA-positive rate and DNA ploidy. For all cases analyzed, patients whose tumors had PCNA-positive rates of less than 10% survived statistically longer than those with tumors with PCNA-positive rates of 10% or more (p < 0.02). When patients were stratified by histopathological stage-I and grade-1 tumors, however, there was no significant difference between the PCNA-positive rate and survival. No difference in survival was observed according to DNA ploidy. The PCNA-positive rates showed a close relation to the different histopathological grades and stages of renal cell carcinoma. For all cases analyzed, high PCNA-positive rates showed poor prognosis. But for patients with histopathological stage-I and grade-1 tumors, the PCNA-positive rates and DNA ploidy did not provide independent prognostic information.