The assessment of proliferating cell nuclear antigen (PCNA) immunostaining in primary gastrointestinal lymphomas and its relationship to histological grade, S + G2 + M phase fraction (flow cytometric analysis) and prognosis

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Abstract
PCNA is a nuclear protein that is synthesized in late G1 and S phases of the cell cycle and is, therefore, correlated with the cell proliferative state. A new monoclonal antibody (PC10) to genetically engineered PCNA has been shown to label proliferating cells in formalin-fixed paraffin-embedded normal human tissues. Previous studies in lymphomas, using various markers of cell proliferation, have shown a strong correlation between indices of cell proliferation and histological grade. These studies have shown that within each histological subtype there is often a wide range of prolifeative indices and that these may be of some prognostic significance. Thirty-one gastrointestinal lymphomas were studied. Our results show that there is a good correlation between PC10 index and histological grade of tumour (0.01 > P>0.001) and also a significant relationship between PC10 index and S + G2 + M phase fraction as measured by flow cytometric analysis (r2= 0.62; P≤0.01). Twenty-three cases were available for survival analysis. In these cases a high PC10 score correlated with poor survival (P=0.04). Based on this series, it appears that there is a significant relationship between PC10 index and histological grade, and between PC10 index and S+G2+M phase as measurred by flow cytometric analysis. In addition, our results suggest that a high PC10 index is an adverse prognostic factor primary gastrointestinal lymphoma.