1138 Clinical significance of proliferating cell nuclear antigen expression in transitional cell carcinoma of the bladder

Abstract

To elucidate the clinical significance of cellular proliferation in transitional cell carcinoma (TCC) of the bladder, the proliferating cell nuclear antigen (PCNA) expression, pS3 and nm23 immunoreactivities, 2c deviation index (2cDI) and 5c exceeding rate (5cER) were evaluated using an image analyzer. The paraffin embedded materials obtained from 77 patients with non-metastatic untreated TCC of the bladder who received total cystectomy were used in this study. The PCNA expression significantly correlated with the pS3 and nm23 immunoreactivities, 2cDI value and 5cER, respectively. The grade significantly correlated with all of the 5 parameters. Similarly, the stage as well as disease progression significantly correlated with all of the parameters except for the nm23 immunoreactivity. In univariate analysis, the prognostic relevance was noted in grade, stage, PCNA expression, p53 immunoreactivity, 2cDI value and 5cER, whereas not in nm23 immunoreactivity. In multivariate analysis, the PCNA expression, followed by 2cDI value, was the most important variable, however, the p53 immunoreactivity and 5cER were not of independent significance. The results suggest that the tumor growth fraction as assessed by the PCNA expression is an important and independent predictor for survival in patients with TCC of the bladder.