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目的 :用针对细胞增殖核抗原 (proliferatingcellnuclearantigen ,PCNA)的抗体检测进展期胃癌细胞的增殖活力 ,探讨其表达及与预后的关系。方法 :用免疫组织化学方法测定了 157例内窥镜活检标本和其中 10例手术切除标本及 10例正常胃粘膜标本的PCNA标记指数 (Lablingindex ,LI)。结果 :PC NA在肿瘤的增殖细胞和正常胃粘膜腺体颈部细胞的核内强染色。PCNALI正常胃粘膜为 3 5%～10 6% ( 6 5± 3 4 ) % ,胃癌活检组织 12 6%～ 68 0 % ( 34 2± 10 7) % ,P <0 0 1。在肝脏和淋巴结转移、浆膜侵犯、腹腔播散、肿瘤大于或等于 6cm和组织学分化差的胃癌PCNALI明显增高 (P <0 0 1)。高PCNALI(≥ 35% ) 5年生存率明显低于低PCNALI( <35% )者 (P <0 0 1)。结论 :PCNALI是一个重要的和独立的预后指标
OBJECTIVE: To detect the proliferative activity of advanced gastric cancer cells by using antibodies directed against proliferating cell nuclear antigen (PCNA) and to investigate its relationship with prognosis. Methods: The PCNA labeling index (Lab) of 157 cases of endoscopic biopsy specimens and 10 cases of resected specimens and 10 cases of normal gastric mucosa specimens were determined by immunohistochemistry. RESULTS: PCNA was strongly nuclear in the proliferating cells of tumors and in the nucleus of normal gastric mucosal glands. The normal gastric mucosa of PCNALI ranged from 35% to 106% (65 ± 34%), and the biopsies of gastric cancer from 12 6% to 68 0% (34 2 ± 10 7%), P <0.01. In the liver and lymph node metastasis, serosal invasion, peritoneal dissemination, tumor greater than or equal to 6cm and poor differentiation of gastric cancer PCNALI was significantly increased (P <0.01). The 5-year survival rate of patients with high PCNALI (≥ 35%) was significantly lower than those with low PCNALI (<35%) (P <0.01). Conclusion: PCNALI is an important and independent prognostic factor