1994 Volume 35 Issue 5 Pages 347-355
The proliferative activities in 4 cases of adenomatous hyperplasia (AH), 13 cases of small liver cell cancer (single hepatocellular carcinoma 2cm or less in the diameter), 17 cases (22 foci) of other hepatocellular carcinoma (HCC) were evaluated by immunohistochemistry for proliferating cell nuclear antigen (PCNA) and by the silver staining technique to demonstrate nucleolar organizer region-associated proteins (AgNORs). The PCNA labeling index of HCC was higher than that of regenerative nodules (RN) in liver cirrhosis, and was correlated with the HCC grade. The PCNA labeling index of AH and well differentiated HCC was within the same limit as in RN. The PCNA positive cells were located focaly at a peripheral zone in AH and well differentiated HCC as well as in RN, whereas they were distributed diffusely or at random in most of moderately and poorly differentiated HCC. The mean numbers of AgNORs per nucleus in HCC increased with its histological grade. Cases with a high labeling index (≥50%) developed a poorer disease free survival rate than those with a low labeling index (<50%). Moreover, the disease free survival rate showed a significant difference between cases with mean AgNORs count 3 or more and those with mean AgNORs count less than 3.
These data suggest that both PCNA labeling index and AgNORs score are considered as a hallmark to estimate a risk of post-operative recurrence.
