Prognostic value of proliferation factors in oral squamous cell carcinoma

ABSTRACT

Purpose: The purpose of this study is to evaluate the value of proliferation factors, Ki67 and PCNA, as prognostic markers predicting the survival and neck metastasis in patients with oral cancer. Methods: 101 patients with HNSCCs, were followed retrospectively for a median period of 60 months(from 16 to 82 months). All tumors were resected surgically and examined by conventional light microscopy, immunohistochemistry. The age, sex, tumor location, clinical stage(size), metastasis, proliferative activity index(assessed by proliferating cell nuclear antigen(PCNA) and Ki67 immunoreactivity) were considered as potential prognostic factors and were correlated with patient survival. Results: Ki67 staining results ranged from 5% to 80% of tumor cell nuclei, with a median of 25%. PCNA staining results ranged from 1% to 90% with a median of 50%. With a cut-off point of 25%, patients with lower Ki67 scores showed survival advantages over those with higher Ki67 scores (p=0.0089). With cut-off point of 50%, patients with lower PCNA scores showed survival advantages over those with higher PCNA scores (p=0.0104). Pathologically neck node positive patients(n=27) showed higher PCNA expression(p=0.02) than pathologically negative neck node patients(n=39). Conclusions: The lower expressions of Ki67 and PCNA were associated with favorable prognosis such as higher survival rate and lower neck node metastasis.