Expression of Proliferating Cell Nuclear Antigen (PCNA) in breast carcinoma and its association with Ki67 and tumor grade in mastectomy specimens

Kalaivani Amitkumar,Balaji R,Saranya Babu,Anandhalakshmi Swaminathan,Bhuvanamhadevi R

doi:10.21276/apalm.2017.1191

Abstract

Background: Breast cancer ranks first among cancer in urban population of India, and 2nd most common in the rural population. Proliferative activity acts as an adjunct and gives prognostic importance in breast cancer. However, the best method for measurement of proliferative rate is controversial. The aim was to evaluate the association between PCNA labeling index (PCNA-LI) and Ki67 labeling index (Ki67-LI) and their correlation with histological grade. Methods: Seventy cases of simple and modified Radical Mastectomy specimens with the diagnosis of carcinoma breast were included in the study. H&E stained sections were examined for assessment of histological grade. IHC scoring was done for the markers Ki-67 and PCNA. Correlation of PCNA with Ki67 and tumor grade was performed. Result: 18 specimens were grade 1 tumors, 36 cases were grade 2 and 16 were grade 3. 90.0% of tumors were positive for PCNA index and Ki-67 positivity was observed in 85.7% cases, median and mean values of PCNA and Ki67 were 52.0, 51.64+/-37.475, and 24.50, 26.17± 24.183 respectively. Final score was divided into low and high index using median value as a cut off. Ki-67 LI showed strong positive correlation with histological grade (p=0.0001). PCNA LI showed positive correlation with histological grade (p=0.041) but no correlation was observed with Ki-67 LI (p=0.232) Conclusion: PCNA marker cannot substitute Ki67 but may be used as an additional marker to assess proliferative activity along with other markers. It may be useful to categorize subgroups with different grades of proliferative activity due to its easy applicability and assessment techniques. DOI: 10.21276/apalm.2017.1191

Highlights

Breast cancer ranks first among cancer in urban population of India, and 2nd most common in the rural population
The aim was to evaluate the association between Proliferating cell nuclear antigen (PCNA) labeling index (PCNA-LI) and Ki67 labeling index (Ki67-LI) and their correlation with histological grade
Sections were stained by Haematoxyllin and eosin (H&E) stain. 64 cases were Infiltrating ductal carcinomas NST, 2 cases were diagnosed as Infiltrating lobular carcinomas, one case of mucinous and comedocarcinoma and two cases were Intracystic papillary carcinoma

Summary

Introduction

Breast cancer ranks first among cancer in urban population of India, and 2nd most common in the rural population. India ranks number one in the numbers of healthy life years lost (DALY - Disability Adjusted Life Years) due to breast cancer. Many prognostic factors have been proposed to help identify the patients in whom there is a chance of recurrence after treatment, and in order to select patients with low clinical stage who should receive adjuvant therapy. In addition to histological grading and clinical staging assessment of proliferative activity acts as an adjunct and gives prognostic importance in many tumors including breast cancer. Proliferative activity acts as an adjunct and gives prognostic importance in breast cancer. The aim was to evaluate the association between PCNA labeling index (PCNA-LI) and Ki67 labeling index (Ki67-LI) and their correlation with histological grade

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Discussion

Conclusion