Expression of proliferating cell nuclear antigen (PCNA) and Ki-67 in soft tissue sarcoma. Is prognostic significance histotype-specific?

APMIS. 1995 Nov;103(11):797-805. doi: 10.1111/j.1699-0463.1995.tb01437.x.


Abnormal patterns of proliferation characterize the behavior of many tumors. Proliferating cell nuclear antigen (PCNA) and Ki-67 are two cell cycle antigens which are expressed in proliferative states. Our study examines the prognostic value of these cell-cycle antigens in soft tissue sarcoma (STS). Paraffin-embedded primary tumor tissues from 185 patients (1980-92) were stained with the anti-PCNA antibody PC-10; 182 of these were stained with the antibody MIB-1 for Ki-67. Using PCNA (< or = 50; > 50%) and Ki-67 (< or = 10; > 10%) indices, we examined and compared metastasis-free survival (MFS) in a mixed-histotype group, as well as after subdivision into MFH and non-MFH groups. Fifty-seven patients developed metastases. The median follow-up for survivors was 6 (2-13) years. In the mixed series, the 2-year MFS for a PCNA index < or = 50 was 76%, and for an index > 50 56%. Survival predicted by Ki-67 index was comparable. PCNA index (but not Ki-67) strongly correlated with the incidence of metastasis in MFH tumors and predicted 2-year MFS of 81 vs 48%. In contrast, Ki-67 index (but not PCNA) strongly correlated with metastasis in non-MFH tumors and predicted 2-year MFS survival of 90 vs 45%. No correlation existed between PCNA and Ki-67 indices in the mixed histotype, MFH or non-MFH groups. In combination, a high PCNA and Ki-67 index correlated with poor survival, a high PCNA and lower Ki-67 index (or vice versa) with an intermediate survival, and low PCNA and Ki-67 indices with the best survival. The pattern of PCNA and Ki-67 expression raises the possibility of histotype specificity.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor
  • Cell Division / immunology
  • Epitopes / analysis*
  • Female
  • Histiocytoma, Benign Fibrous / chemistry
  • Histiocytoma, Benign Fibrous / mortality
  • Histiocytoma, Benign Fibrous / pathology
  • Humans
  • Ki-67 Antigen
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Proteins / analysis*
  • Nuclear Proteins / analysis*
  • Prognosis
  • Proliferating Cell Nuclear Antigen / analysis*
  • Sarcoma / chemistry
  • Sarcoma / mortality
  • Sarcoma / pathology*
  • Soft Tissue Neoplasms / chemistry
  • Soft Tissue Neoplasms / mortality
  • Soft Tissue Neoplasms / pathology*


  • Biomarkers, Tumor
  • Epitopes
  • Ki-67 Antigen
  • Neoplasm Proteins
  • Nuclear Proteins
  • Proliferating Cell Nuclear Antigen