Abstract
BACKGROUND: The clinical characteristics of cholesteatomas, namely invasion, migration, altered differentiation, aggressiveness, and easy recurrence, are traits typically associated with the neoplastic cells. Using the proliferating cell nuclear antigen (PCNA) immunohistochemical staining method, we attempted to compare the proliferative features of human middle ear cholesteatoma with tympanic membrane of chronic otitis media (COM) and normal postauricular skin and to delineate the possible role of this immunohistochemical staining method in assessing the middle ear cholesteatoma. METHODS: We used ABC (avidin-biotin complex) technique and monoclonal antibody to PCNA to evaluate the expression of PCNA in 37 cases of cholesteatoma epithelium, 7 cases of tympanic membrane of chronic otitis media, and 21 cases of normal postauricular skin. RESULTS: The PCNA-positive cell rate in basal, parabasal, and upper layer of each cholesteatoma epithelium tissue was 78%, 68%, and 41% respectively. In the epithelium of the tympanic membrane, PCNA-positive cell rate in basal, parabasal, and upper layer was 86%, 71%, and 43% respectively. The PCNA-positive cell rate in normal postauricular skin tissue was 71%, 67%, and 34% respectively. The results of this report indicate that the proliferative activity in cholesteatoma is similar to that of the tympanic membrane of chronic otitis media and normal postauricular skin (P＞0.05). CONCLUSION: we found that cholesteatoma and tympanic membrane have a higher PCNA-positive cell rate than normal postauricular skin, but no statistical significance was observed among the epithelium layer. We conclude that despite its clinical behavior, which is similar to neoplastic cells, cholesteatoma itself is not a real tumor.
Published Version
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