Proliferating cell nuclear antigen as a prognostic factor after total mesorectal excision of stage II-III rectal cancer.

Abstract

BACKGROUND:

Proliferating cell nuclear antigen (PCNA) is an auxiliary protein of DNA polymerase delta that is tightly associated with sites of DNA replication; whether PCNA is a definite prognostic factor remains controversial. This study determined the clinicopathological factors associated with the long-term oncological outcome after radical resection of stage II-III rectal cancer, focusing on PCNA.

METHODS:

We retrospectively reviewed 135 consecutive patients who underwent curative surgery for stage II-III rectal cancer between August 2001 and April 2004. Prognostic factors including immunohistochemical PCNA expression and the clinical outcome were evaluated.

RESULTS:

The PCNA index correlated with lymph node metastasis (P = 0.010). A multivariate analysis identified two independent factors that significantly affected both disease-free and overall survival: lymph node metastasis and PCNA index. With a median follow-up period of 60 months (range 8-87 months), both 5-year disease-free and overall survival of the low PCNA group were significantly higher than those of the high PCNA group (71.8% versus 32.0%, P < 0.001; 83.9% versus 50.0%, P < 0.001, respectively).

CONCLUSION:

For patients undergoing curative resection for rectal cancer, pathological N stage and high PCNA expression can provide valuable prognostic information about survival. This study suggests that the PCNA index may be used as an independent prognostic factor in stage II-III rectal cancer patients.

• Authors: Jung Wook Huh, Hyeong Rok Kim, Young Jin Kim
• Journal: Annals of surgical oncology (Ann Surg Oncol) Vol. 16 Issue 6 Pg. 1494-500 (Jun 2009) ISSN: 1534-4681 [Electronic] United States
• PMID: 19267156 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor
• Proliferating Cell Nuclear Antigen

Topics

• Adenocarcinoma (metabolism, mortality, pathology, surgery)
• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor (biosynthesis)
• Female
• Humans
• Immunohistochemistry
• Lymphatic Metastasis
• Male
• Middle Aged
• Prognosis
• Proliferating Cell Nuclear Antigen (biosynthesis)
• Rectal Neoplasms (metabolism, mortality, pathology, surgery)
• Retrospective Studies
• Treatment Outcome