Proliferating cell nuclear antigen (PCNA) immunoreactivity in stage I endometrial carcinoma: A new prognostic factor

The objective of this study was to evaluate the prognostic significance of proliferating cell nuclear antigen (PCNA) immunoreactivity in tumor cells in patients with endometrial carcinoma. A population of 74 patients with FIGO stage I endometrioid adenocarcinoma of the endometrium, who underwent primary surgical management, were selected from January, 1986 to June, 1993 at the Department of Gynecologic and Obstetrics, Ancona University. The archival paraffin blocks from the uterine tumor specimens were recut and assessed for histologic re-examination and PCNA immunostaining (PC 10 monoclonal antibody; Dako, Denmark). A significant increase in PCNA index was observed with respect to nuclear grade (P<0.001) and depth of myometrial invasion (P<0.001), with the highest percentage values in nuclear grade 3 tumors and in greater than or equal to 50% myometrial invasion. A PCNA index greater than or equal to 50% was related significantly to disease-recurrence risk (P<0.001) and PCNA index seems to be a significant prognostic parameter in stage I endometrial carcinoma, for disease-free survival.