The clinical significance of expression of proliferating cell nuclear antigen in transitional cell carcinoma of the bladder : The comparative study with histopathological grade and clinical stage

Park, Hong Suk; Cheon, Jun; Kim, Han Kyeom; Yoon, Duck Ki; Koh, Sung Kun

Abstract

The expression of proliferating cell nuclear antigen (PCNA) was assessed immunohistochemically in 47 cases of transitional cell carcinoma of the bladder and 3 cases of normal bladder with anti- PCNA/cyclin monoclonal antibody, using routinely processed tissue sections without interferring with histopathological diagnosis. The PCNA expression rates were compared with Ash histologic grade and clinical stage. In bladder cancer, the PCNA expression rate ranged from 3.8% to 32.7 % (mean value 11.2 %). Bladder cancer with Ash grade IV showed the highest PCNA expression rate (mean value 15.8 % ) and cancer with Ash grade I showed the lowest PCNA expression rate (mean value 8.3%). There were statistically significant differences of PCNA expression rates according to Ash grades (P=0.02. Kruskal-Wellis test). When clinical stage was analyzed to assess the relationship to PCNA expression rate invasive bladder cancers were associated ith higher PCNA expression rate then superficial bladder cancer (mean value of stage A; 8.7 %, stage B and C; 16.5 %). and the difference was statistically significant (P=0.003. Kruskal-Wallis test). Also, there was positive linear relationship between PCNA expression rate and Ash grade with regression analysis (r=0.573, P<0.0001, Y=4.41X +0.79). These results suggest that PCNA is useful as a unclear antigenic marker of cellular proliferation and offers an opportunity for analyzing cell kinetics successfully in formalin-fixed, paraffin-embeded tissue sections of transitional cell carcinoma of the bladder. It will be merited as a simple and powerful method to detect transitional cell carcinoma of the bladder with high potential of invasion, metastasis and clinical progression.