AIM: Since the prognostic significance of the Nucleolar Organizer Regions (AgNORs) analysis in tumour pathology is still a matter of debate, a prospective study was performed in a small series of renal cell carcinomas in order to clarify their prognostic value. METHODS: In 1990, 3*m thick sections from 21 renal cell carcinomas (3 grade 1, 15 grade 2 and 3 grade 3; 15 stage pT2 and 6 pT3), fixed in 95% ethanol and embedded in paraffin, were stained with the method of Ploton. All the black dots within nuclei from 200 tumour cells were counted by optical sectioning and the mean AgNOR number per nucleus was calculated in each case. Six years later, the follow-up of the patients was recorded and a Kaplan-Meier univariate survival analysis was performed. RESULTS: Data on the distribution of AgNORs in renal cell carcinomas had been previously reported (Pich et al. Pathol Res Pract 187, 482-6, 1991): the mean AgNOR counts for the whole series was 6.13, the median 5.94 and SD 1.78. No association was found between AgNORs and histologic grade and stage. At the time of survival analysis (June 1996), 13/21 patients were alive without recurrence, 6 were dead of the disease and 2 dead of myocardial infarction. The 6 year survival rates were 100% for patients with 5.94 AgNORs per cell or fewer but only 60% for patients with more than 5.94 AgNORs per cell (p=0.01). Age, histologic grade and stage did not correlate to patients outcome. CONCLUSIONS: This prospective study clearly indicates that AgNOR counts have a strong prognostic value in renal cell carcinoma. AgNOR analysis is a simple and inexpensive technique which allows the simultaneous evaluation of cell proliferation and histology in the same specimen, and may be regarded as a reliable diagnostic and prognostic indicator in tumour pathology.
Prognostic value of AgNORs in renal cell carcinoma: results of a prospective study
PICH, Achille;
1996-01-01
Abstract
AIM: Since the prognostic significance of the Nucleolar Organizer Regions (AgNORs) analysis in tumour pathology is still a matter of debate, a prospective study was performed in a small series of renal cell carcinomas in order to clarify their prognostic value. METHODS: In 1990, 3*m thick sections from 21 renal cell carcinomas (3 grade 1, 15 grade 2 and 3 grade 3; 15 stage pT2 and 6 pT3), fixed in 95% ethanol and embedded in paraffin, were stained with the method of Ploton. All the black dots within nuclei from 200 tumour cells were counted by optical sectioning and the mean AgNOR number per nucleus was calculated in each case. Six years later, the follow-up of the patients was recorded and a Kaplan-Meier univariate survival analysis was performed. RESULTS: Data on the distribution of AgNORs in renal cell carcinomas had been previously reported (Pich et al. Pathol Res Pract 187, 482-6, 1991): the mean AgNOR counts for the whole series was 6.13, the median 5.94 and SD 1.78. No association was found between AgNORs and histologic grade and stage. At the time of survival analysis (June 1996), 13/21 patients were alive without recurrence, 6 were dead of the disease and 2 dead of myocardial infarction. The 6 year survival rates were 100% for patients with 5.94 AgNORs per cell or fewer but only 60% for patients with more than 5.94 AgNORs per cell (p=0.01). Age, histologic grade and stage did not correlate to patients outcome. CONCLUSIONS: This prospective study clearly indicates that AgNOR counts have a strong prognostic value in renal cell carcinoma. AgNOR analysis is a simple and inexpensive technique which allows the simultaneous evaluation of cell proliferation and histology in the same specimen, and may be regarded as a reliable diagnostic and prognostic indicator in tumour pathology.
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