Prognostic significance of PCNA grade in malignant melanoma

Proliferating cell nuclear antigen (PCNA) grade (a semi-quantitative assessment of the entire tumor profile) and estimation whether PCNA grade is low (0-50% positive cells) or high (51-100% positive cells) has been demonstrated to be of prognostic significance in gastric carcinoma. Sixteen vertical growth phase melanomas with 8 or more years of clinical follow-up were reacted with antibody to PCNA. PCNA grade was independently evaluated by both authors without knowledge of clinical outcome. PCNA grade was subsequently correlated with clinical outcome and other prognostic indicators. Agreement in assigning PCNA grade was noted between the two observers in 13/16 cases. However, PCNA grade failed to accurately predict patient survival or death. Additionally, PCNA grade was not significantly correlated with other recognized prognostic attributes. While interpretation of the prognostic significance of PCNA grade based upon this small series of cases should be conservative, a semi-quantitative estimate of PCNA-positive cells appears to have little utility in predicting the clinical outcome in malignant melanoma.