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为了探讨ＰＣＮＡ表达与肾盂输尿管癌病理分期、细胞分级、复发及预后的关系，作者采用免疫组化Ｓ－Ｐ法对４７例肾盂输尿管癌ＰＣＮＡ增殖指数进行研究。结果表明：肾盂输尿管癌ＰＣＮＡ增殖指数随病理分期，细胞分级升高而增高，Ｔ３加Ｔ４ＰＣＮＡ增殖指数明显高于Ｔ１加Ｔ２（Ｐ＜０．０１）．ＧＰＣＮＡ增殖指数明显高于Ｇ１加Ｇ２（Ｐ＜０．００１），ＰＣＮＡ增殖指数高者（Ⅲ加Ⅳ级）术后膀胱癌再发率为６０％（１２／２０）明显高于增殖指数低者（Ⅰ加Ⅱ级）２２．２％（６／２７）Ｐ＜０．０１。ＰＣＮＡ增殖指数Ⅲ加Ⅳ级同时伴发尿路上皮多器官癌占３５％（７／２０），Ⅰ加Ⅱ级同时伴发尿路上皮多器官癌占７．４％（２／２７）Ｐ＜０．０５。ＰＣＮＡ增殖指数Ⅰ加Ⅱ级术后局部复发转移率为７．４％〔２／２７），Ⅲ加Ⅳ级局部复发转移率为４０％（８／２０），Ｐ＜０．０５。ＰＣＮＡ增殖指数Ⅰ加Ⅱ级５年生存率为８６．７％（１３／１５），Ⅲ加Ⅳ级５年生存率为３５．７％（５／１４）Ｐ＜０．０５。提示ＰＣＮＡ增殖指数与肾盂输尿管癌的病理分期，细胞分级有关，是低分化、侵袭性以及同时或相继发生尿路上皮多器官癌的重要特征，可能是判断肾盂输尿管癌预后的重要指标。
To investigate the relationship between PCNA expression and the pathological staging, cell grade, recurrence, and prognosis of renal pelvic ureter cancer, the authors used immunohistochemical S-P method to study the proliferation index of PCNA in 47 cases of renal pelvic ureteral cancer. The results showed that the proliferative index of PCNA in pelvis of renal pelvis increased with the pathological stage and cell grading, and the proliferation index of T3 plus T4PCNA was significantly higher than that of T1 plus T2 (P<0.01). The proliferative index of GPCNA was significantly higher than that of G1 plus G2 (P<0.001). The recurrence rate of bladder cancer after high PCNA proliferation index (III plus IV) was 60% (12/20) significantly higher than those with low proliferative index. (I plus II) 22.2% (6/27) P<0.01. PCNA proliferation index III plus grade IV accompanied by urothelial multiple organ cancer accounted for 35% (7/20), I plus grade II with urinary tract epithelial multiple organ cancer accounted for 7.4% (2/27) P< 0.05. The rate of local recurrence and metastasis after PCNA proliferation index I and II was 7.4% (2/27), and the local recurrence and metastasis rate of III plus IV was 40% (8/20), P<0.05. The 5-year survival rate of PCNA proliferation index I and II was 86.7% (13/15), and the 5-year survival rate of III plus IV was 35.7% (5/14) P<0.05. It is suggested that the proliferation index of PCNA is related to the pathological stage and cell grading of ureteropelvic carcinoma. It is an important feature of poorly differentiated, invasive and simultaneous or sequential urinary tract polycarcinoma of the urinary tract. It may be an important indicator for judging the prognosis of ureteral cancer of the renal pelvis.