Prognostic significance of PCNA expression in laryngeal cancer.

OBJECTIVE: To assess the prognostic value of proliferating cell nuclear antigen (PCNA) in laryngeal carcinoma and its relation with other known prognostic clinicopathologic variables. DESIGN: A retrospective cohort study of 92 patients chosen randomly from patients treated between 1964 and 1993 with the diagnosis of laryngeal cancer. Prognostic factors including PCNA expression, grade, lymphovascular invasion, depth of tumor margins, neck metastasis, and clinical outcome were evaluated. SETTING: Hacettepe University Medical Faculty, Ankara, Turkey. PATIENTS: Eighty-five men and 7 women operated on for squamous cell carcinoma of the larynx were studied. Sixty-nine patients had total and 20 patients had partial laryngectomy with neck dissection, and 3 patients had endolaryngeal tumor excision. INTERVENTION: Hematoxylin and eosin-stained sections were reevaluated for grade, lymphovascular invasion, and depth of tumor margins; sections stained with monoclonal antibody against PC10 were examined for PCNA expression. RESULTS: The PCNA index correlated with grade, lymphovascular invasion, depth of tumor margins, neck metastasis, and local-regional recurrence. The PCNA index values of patients with occult metastasis were significantly higher than those of patients without metastasis (P=.006). CONCLUSIONS: The PCNA index is a more sensitive variable than grade in predicting tumor proliferation, occult lymph node metastasis, and prognosis. These results suggest that the PCNA index can be used in decision making for treatment and assessment of prognosis in laryngeal carcinomas.