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How should PCNA be assessed? Total of stained cells or only the most intensely stained ones?

OBJECTIVE: This study aimed to analyse whether a marker of proliferative activity (PCNA) could provide a prognosis of tumor evolution and to determine whether different interpretation criteria could alter the results. METHOD: The presence of PCNA in 59 patients of state II (T2 NO,1 MO) mammary carcinoma was determined. RESULT: Numerical proportions of total and intensely stained cells were established. These data were compared with anatomopathological parameters. A significant association between higher cyclin values and worse histological and nuclear grading was encountered, particularly in patients with a "negative axilla" using the PCNA index. Cyclin values were not significant in relation to any parameters when indices from the intensely stained cells were considered exclusively. CONCLUSION: Higher nuclear (NG3) and histological (HGIII) grading, associated with a high PCNA index (>50), distinguish high-risk patients, and it is more appropriate considering all the stained cells as representative of PCNA indices, thus reflecting tumor aggressiveness.

Breast Cancer; Prognostic Factor; Proliferating cell nuclear antigen (PCNA/cyclin)


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