The clinical value of proliferating cell nuclear antigen and silver-binding nucleolar organizer region in the malignant transformation of ovarian endometriosis

Objective To investigate the clinical value of proliferating cell nuclear antigen(PCNA)and nucleolar organizer region(NOR)score in the malignant transformation of ovarian endometriosis.Methods Tissue specimens of 30 ovarian carcinoma arising in association with endometriosis and 15 atypical endometriosis were immunostained with PCNA and stained with AgNOR.And 30 specimens of endometriosis served as controls.Results In comparison to endometriosis the values of the two indicators of ovarian carcinoma and atypical endometriosis were significantly greater,and the values of the two indicators of ovarian carcinoma were higher than those of atypical endometriosis(P 0.05).The values of the two indicators of malignant areas and malignant transformation areas in ovarian carcinoma were higher than the endometriosis areas,and the values of the two indicators of malignant areas were higher than the malignant transformation areas(P 0.05).There was a significant relationship between PCNA,AgNOR scores and stage of the tumor(P 0.05).The Kaplan-Meier curves for recurrence-progression free survival revealed that patients with AgNOR score 5.64 and PCNA labelling index 49.22% had a worse prognosis than those with 5.64 and 49.22%,respectively.Conclusion AgNOR scores and PCNA indices can discriminate between benign and malignant endometriosis,and these proliferation markers may determine the stage of endometriosis-associated ovarian carcinoma.Endometriosis and atypical endometriosis may be the precursor lesions of endometriosis-associated ovarian carcinoma.