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Abstract
PURPOSE: The immunoexpression of the PC-10 monoclonal antibody for the proliferating cell nuclear antigen is claimed to have prognostic value in diverse tumors, but previous data on posterior uveal melanoma are conflicting. The aim of the current study was to investigate further the potential value of the PC-10 antibody in predicting tumor-related death after enucleation for posterior uveal melanoma. METHODS: One observer calculated the number of cells after antigen retrieval that showed immunoreactivity for PC-10 in the high expression areas of 212 specimens containing posterior uveal melanomas. Survival data for all patients were entered into stepwise multivariate Cox regressions that included other potential prognostic covariates. The prognostic accuracy was assessed by receiver operating characteristic curve analysis. RESULTS: The only covariates of statistically significant prognostic value were the number of cells featuring immunoreactivity for PC-10 and the largest tumor diameter. When using the median PC-10 count as the cutoff, the cumulative 10-year survival proportion was 84% for the low PC-10 count group and 40% for patients harboring tumors with high PC-10 counts. Those with tumors featuring high PC-10 counts had a 5.8 times greater risk to die of metastatic melanoma. However, the prognostic accuracy of the PC-10 count was not significantly better than that of the largest tumor diameter, presumably because of insufficient statistical power. CONCLUSIONS: The number of cells showing immunoreactivity for the PC-10 antibody may be used to assess prognosis in posterior uveal melanoma, provided that antigen retrieval is performed. Additional work using a larger sample size is warranted for better comparison of the predictive accuracy with that of other prognostic markers.