Proliferating cell nuclear antigen may be superior to argyrophilic nucleolar organizer regions in predicting shortened survival of patients with non-small cell lung cancer.

We examined proliferating cell nuclear antigen (PCNA) in 102 patients with surgically treated non-small cell lung cancer (NSCLC). PCNA labelling index (LI) tended to be higher in tumours of higher stages than those of early stages, in squamous cell carcinomas than adenocarcinomas, or in poorly differentiated adenocarcinoma than in well-differentiated. A positive correlation was observed between the PCNA LI and argyrophilic nucleolar organizer regions (Ag-NOR) count which we previously examined (r = 0.31, P = 0.002). In survival analysis of 79 patients who died of lung cancer, only age, stage and PCNA LI were found to be significant prognostic factors on multivariate analysis among seven potential prognostic factors including sex, age, year of operation, histological type, stage, Ag-NOR count, and PCNA LI. We conclude that PCNA may be superior to Ag-NOR in predicting shortened survival of patients with non-small cell lung cancer. PCNA staining can be performed with ease and it may be applied in a clinical laboratory on a routine basis to help predict prognosis of NSCLC.