Die Bedeutung der PCNA-Proliferationsfraktion für die Prognose des Ovarialkarzinoms

The prognostic value of the PCNA-proliferative fraction as compared to conventional clinical and histomorphological factors (FIGO-stage, tumour type, histological grading, lymphnode status, size of residual tumour) was investigated in 81 ovarian cancer patients. Categorisation of PCNA-expression into tumours with low and high proliferative activity ( 34%) or classification of PCNA as a continuous variable did not prove advantageous. PCNA-proliferative fraction was significantly directly correlated with histological grading (p = 0.006). Tumours with a high PCNA expression had a greater frequency of macroscopically detectable residual tumours. In univariate survival analyses patients with highly proliferating tumours had a worse outcome than patients with tumour of low proliferation (PCNA 34%, p = 0.08). The result was consistend in subgroup of FIGO III-tumours (p=0.031, PCNA <20%/≥20%), of FIGO I-tumours (p= 0.036, PCNA <20%/≥20%), of carcinomas without postoperative residual tumour (p=0.03 PCNA <20%/≥20%) and also of FIGO III-tumour without residual tumours (p=0.041 PCNA <20%/≥20%). Multivariate survival analysis comprising all the patients revealed PCNA expression (<20%/≥ 20%) as an independent prognostic factor second to the size of the residual tumour. In patients with FIGO III-tumours PCNA proves significant as an independent factor after the size of the residual tumour was removed from the model. Thus, PCNA provides additional information which may prove beneficial in determining prognostic estimates for ovarian cancer.