恶性纤维组织细胞瘤PCNA与AgNOR定量检测及其预后意义

目的为探讨恶性纤维组织细胞瘤的增殖细胞核抗原（PCNA）及核仁组成区嗜银蛋白（AgNOR）定量检测与肿瘤恶性度及预后的关系。方法应用免疫组织化学杂色LSAB法及AgNOR染色法对46例资料完整有随访结果的恶性纤维组织细胞瘤（MFH）手术切除标本进行染色以显示PCNA及AgNOR，彩色病理图像分析系统定量检测。结果肿瘤细胞核PCNA过表达及AgNOR计数与患者生存期呈负相关（rPCNA＝－0．6248、rAgNOR＝－0．5941，P＜0.01）；PCNA及AgNOR定量高值组较之定量低值组患者生存期短（P＜0．01）；肿瘤有转移组PCNA及AgNOR定量高于无转移组（P＜0．01）；肿瘤位置深在组PCNA及AgNOR定量高于肿瘤位置浅表组（P＜0．01）。结论肿瘤细胞核PCNA及AgNOR定量与患者生存期密切相关，与肿瘤转移及位置深浅等反映肿瘤恶性度的指标亦密切相关，提示肿瘤细胞核PCNA及AgNOR定量对于判断恶性纤维组织细胞瘤恶性度及预后的意义值得重视。

The prognostic significance of quantitative detection of PCNA and AgNOR in malignant fibrous histiocytoma

objective The study disclosed between the prognostic significance and quantitative detection of Proliferating cell nuclear antigen (PCNA) and AgNOR in Malignant Fibrous Histiocytoma (MFH). Methods Immunohistochemical techniques and color image analysis system and AgNOR staining methods were used to quantify the expression intensity PCNA and silverbinding nucleolar organizer regions in 46 case of MFH with complete data and following-up results. Results A negative relation(rPCNA=- 0.6248,rAgNOR= - 0. 5941, P<0. 01 )was seen between quantitative PCNA or AgNOR and surviyal period of the patients. The survival period of high PCNA or AgNOR quantitative group was longer than that of low PCNA or AgNOR quantitative group(P <0.01) ; the PCNA or AgNOR quantity of the metastatic group was higher than that of the no metastatic group (P <0. 01) ; the PCNA or AgNOR quantity of the deep tumor group was higher than that of the superficial tumor group (P<0. 01). Conclusion The close relation between the survival period and the quantity of PCNA and AgNOR in the tumor nuclear was seen. The variable quantities of PCNA and AgNOR were closely related to the metastasis and superficial or deep site of the MFH,which are about malignant degree of the tumor. Therefore, it should be attached importance to the significance of the PCNA and AgNOR quantity in the tumor cell nucleus, which infer malignant degree and prognosis of MFH.