Proliferating cell nuclear antigen (PCNA) in high‐grade malignant fibrous histiocytoma: Prognostic value in 48 patients

Abstract

Grading based on histopathologic features is used to predict survival in soft-tissue sarcoma. However, variations in clinical behavior between tumors of the same grade motivate a search for additional factors that correlate with prognosis. Proliferating cell nuclear antigen (PCNA) is expressed in proliferating cells during the G1, S and G2-phases. To evaluate a prognostic implication of PCNA, the tumors of 48 patients with malignant fibrous histiocytomas (13 grade III, 35 grade IV) with a minimum follow-up of 2 years were immunohistochemically studied. We used PC10, a monoclonal antibody (MAb) directed against PCNA, which allows cell proliferation in formalin-fixed, paraffin-embedded tumor tissue to be evaluated. We applied a semiquantitative PCNA grading scheme to all stained nuclei of an entire slide. The 3-year metastasis-free survival rate was 0.87 for patients in grade A (low PLNA rate), and 0.14 for patients in grade C (high PLNA). Our findings show that immunohistochemical evaluation of cell kinetics in soft-tissue sarcomas by PCNA might be a useful adjunct to conventional tumor grading.

Immunoglobulin G is present in a wide variety of soft tissue tumors and correlates well with proliferation markers and tumor grades

“…19 There also are reports about the prognostic value of PCNA in other types of sarcomas. 8,[20][21][22] Levine et al reported that high-level Ki-67 expression was an independent prognostic indicator that correlated with a poor outcome in patients with sarcoma. 10 Similar conclusions were reached in other studies.…”

Flow cytometric S-phase fraction in soft-tissue sarcoma: prognostic importance analysed in 160 patients

“…P-value for highrisk group = 0.1 DISCUSSION S-phase fraction (SPF) has been identified as a prognostic factor in several malignancies, breast cancer, non-small-cell lung cancer, colorectal cancer and carcinoma of the ovary (for review, see Merkel and McGuire, 1990). In soft-tissue sarcoma, several markers of proliferation have yielded prognostic information (Ueda et al, 1989;Stenfert Kroese et al, 1990;Becker et al, 1991;Alho et al, 1993;Oda et al, 1993;Choong et al, 1994;Dreinhofer et al, 1994;Drobnjak et al, 1994), but SPF has not been thoroughly tested together with other strong clinicopathological factors in a multivariate analysis. In 100 of 260 samples, SPF could not be calculated, a fact that restricts the usefulness of the method.…”

“…Proliferating cell nuclear antigen (PCNA) and Ki-67 have been associated with poor prognosis (Ueda et al, 1989;Stenfert Kroese et al, 1990; Oda et al, 1993;Choong et al, 1994;Dreinhofer et al, 1994;Drobnjak et al, 1994), whereas others have failed to show this (Herzberg et al, 1992). Moreover, a high fraction of cells in S-or S+G2-phase, as determined by flow cytometry, has been shown to be prognostic (Becker et al, 1991;Alho et al, 1993) and has also been used to identify patients with short-term response to chemotherapy (Schmidt et al, 1993).…”

Prognostic Significance of Activated AKT Expression in Soft-Tissue Sarcoma

“…Mitotic activity usually reflects proliferative potential of tumors and is commonly used for characterization of STS, but interobserver and intraobserver discrepancy in mitotic counting has been reported (7). Therefore, more objective markers such as labeling index (LI) for Ki-67 (8 -11), proliferating cell nuclear antigen (12), and argyrophilic nucleolar organizer region counting (13,14) have been introduced in the estimation of proliferative activity.…”