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Proliferating Cell Nuclear Antigen Expression and Argyrophilic Nucleolar Organizer Regions as Factors Influencing Prognosis of Surgically Treated Lung Cancer Patients¹

Departments of Surgery II [T. I., S. K., M. T., K. S., K. S.] and Medical Informatics [K. A.], Faculty of Medicine, Kyushu University, Fukuoka 812, Japan

Cell proliferation in 211 primary non-small cell lung carcinomas was assessed by using an immunostaining of proliferating cell nuclear antigen (PCNA) and a silver staining of argyrophilic nucleolar organizer region (Ag-NOR). More than 5% PCNA positive cells was designated PCNA(+), and less than 5% was PCNA(-). A mean number or more of the Ag-NOR was a high Ag-NOR count, and less than the mean number was a low Ag-NOR count. The proportion of the tumors with PCNA(+) and high Ag-NOR counts showed an increase in patients in an advanced stage of the disease (P < 0.05). In 125 patients with stage I disease, the 5-year survival rate was 20% in patients with PCNA(+) and high Ag-NOR counts, compared with 47% in those with either PCNA(+) or high Ag-NOR counts and 76% in those with PCNA(-) and low Ag-NOR counts (P < 0.05). Our data suggest that the tumors with PCNA(+) and high Ag-NOR counts have a high proliferative activity. The combination analysis of PCNA and Ag-NOR may be useful in assessing prognosis in lung cancer, even in stage I disease.

¹ This work was supported in part by a Grant-in-Aid for General Scientific Research from the Japanese Ministry of Education, Science, and Culture.

² To whom requests for reprints should be addressed, at Department of Surgery II, Faculty of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812, Japan.

Received 3/25/93. Accepted 8/ 9/93.

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