Abstract
Cell proliferation was assessed using immunostaining for proliferative cell nuclear antigen in 10 patients with familial adenomatous polyposis (10 normal-appearing mucosa, 19 adenoma and 3 adenocarcinoma specimens) and 6 control subjects (rectosigmoid mucosal biopsies). The total labeling index (percentage ratio of the number of labeled cells to the total number of cells in a column) was 31.70+/-9.32% (mean+/-SD) in adenocarcinoma, 27.95+/-4.24% in adenoma (p<0.001 versus normal-appearing mucosa), 19.54+/-3.46% in normal-appearing mucosa (p<0.01 versus control mucosa) and 13.73+/-5.19% in control mucosa. Adenomas showed hyperproliferation and upward expansion of the proliferative zone. When adenomas were classified by size, their diameter was related to the proliferative activity (r=0.73, p<0.01). The normal-appearing mucosa already showed changes in cell proliferation. In an animal study, a linear correlation between the labeling index for proliferative nuclear cell antigen and that for bromodeoxyuridine was demonstrated in rat colonic mucosa (r=0.96, p<0.001). These results suggest that immunostaining for proliferative cell nuclear antigen can be used as a convenient and precise method of studying cell proliferation kinetics and that the increase of the proliferative activity of adenomas in proportion to their size provides some support for the adenoma-carcinoma sequence.
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