The analysis of the argyrophilic nucleolar organizer regions (AgNORs) is useful for distinguishing benign and malignant cells and for predicting the evolution of some neoplasias. However, contrasting results are found in different tumours. We have analysed AgNORs expression in renal, bladder and pharyngeal carcinomas, melanocytic lesions of the skin and multiple myeloma (MM) to clarify their role in tumor detectoin and prognosis. Sections from formalin fixed, paraffin embedded biopsies were stained with the method of Ploton; the mean AgNOR number and their spatial distribution within the nucleus (configuration) were assessed examining 100 neoplastic cells. AgNOR counts and histologic grade are highly associated in bladder urotheliomas (6.14 for G1, 7.52 for G2, 13.25 for G3) and MM (3.18 for G1, 4.36 for G2, 6.13 for G3); slightly associated in renal cell carcinomas (5.35 for G1, 5.62 for G2, 7.99 for G3) and non associated in pharyngeal carcinomas (11.1 for G2, 10.27 for G3). AgNOR number is also related to the degree of malignancy in melanocytic lesions (2.71 for blue nevi,2.89 for benign nevi, 3.62 for cellular blue nevi, 7.71 for malignant melanomas and 8.33 for malignant cellular blue nevi). Few, large and grouped AgNORs are found in well differentiated MM and benign melanocytic lesions; numerous, small and dispersed AgNORs are seen in poorly differentiated MM and bladder, renal or pharyngeal carcinomas and malignant melanocytic lesions. Significant association with prognosis is found in pharyngeal carcinomas (5 year survival: 68% for cases with <10.31 AgNOR/cell, 20% for cases with >10.31 AgNORs) and MM (5 year survival 46% for cases with <4.62 AgNOR/cell, 7% for cases with >4.62 AgNORs; in MM the configuration too is related to prognosis: median of survival 64 months for thigtly grouped, 16.3 for partially grouped and 5 for dispersed AgNORs). Our results indicate that AgNOR counts are useful in detection and prognosis of some neoplasias. However, strictly controlled and standardized procedures are necessary for a reliable evaluation of AgNORs, as their number can depend on the reaction time, section thickness, fixation procedures and counting methods. On the contrary, the AgNOR configuration is partly independent from these variables, is also related to histologic grade and prognosis and may be rapidly evaluated. Finally, AgNOR analysis is particularly suitable in small biopsies, in which permits the simultaneous evaluation of the morphology and tumour cell kinetics.
Role of the argyrophilic nucleolar organizer regions (AgNORs) in tumour detection and prognosis
PICH, Achille;
1993-01-01
Abstract
The analysis of the argyrophilic nucleolar organizer regions (AgNORs) is useful for distinguishing benign and malignant cells and for predicting the evolution of some neoplasias. However, contrasting results are found in different tumours. We have analysed AgNORs expression in renal, bladder and pharyngeal carcinomas, melanocytic lesions of the skin and multiple myeloma (MM) to clarify their role in tumor detectoin and prognosis. Sections from formalin fixed, paraffin embedded biopsies were stained with the method of Ploton; the mean AgNOR number and their spatial distribution within the nucleus (configuration) were assessed examining 100 neoplastic cells. AgNOR counts and histologic grade are highly associated in bladder urotheliomas (6.14 for G1, 7.52 for G2, 13.25 for G3) and MM (3.18 for G1, 4.36 for G2, 6.13 for G3); slightly associated in renal cell carcinomas (5.35 for G1, 5.62 for G2, 7.99 for G3) and non associated in pharyngeal carcinomas (11.1 for G2, 10.27 for G3). AgNOR number is also related to the degree of malignancy in melanocytic lesions (2.71 for blue nevi,2.89 for benign nevi, 3.62 for cellular blue nevi, 7.71 for malignant melanomas and 8.33 for malignant cellular blue nevi). Few, large and grouped AgNORs are found in well differentiated MM and benign melanocytic lesions; numerous, small and dispersed AgNORs are seen in poorly differentiated MM and bladder, renal or pharyngeal carcinomas and malignant melanocytic lesions. Significant association with prognosis is found in pharyngeal carcinomas (5 year survival: 68% for cases with <10.31 AgNOR/cell, 20% for cases with >10.31 AgNORs) and MM (5 year survival 46% for cases with <4.62 AgNOR/cell, 7% for cases with >4.62 AgNORs; in MM the configuration too is related to prognosis: median of survival 64 months for thigtly grouped, 16.3 for partially grouped and 5 for dispersed AgNORs). Our results indicate that AgNOR counts are useful in detection and prognosis of some neoplasias. However, strictly controlled and standardized procedures are necessary for a reliable evaluation of AgNORs, as their number can depend on the reaction time, section thickness, fixation procedures and counting methods. On the contrary, the AgNOR configuration is partly independent from these variables, is also related to histologic grade and prognosis and may be rapidly evaluated. Finally, AgNOR analysis is particularly suitable in small biopsies, in which permits the simultaneous evaluation of the morphology and tumour cell kinetics.
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