AgNOR expression was analysed in pharyngeal carcinoma, multiple myeloma, thymoma, male breast cancer, prostate carcinoma, renal cell carcinoma and adult acute myelogeneous leukemia. In all these tumors, AgNOR counts showed a strong prognostic significance and appeared as an independent variable in the Cox multivariate analysis. In addition, AgNORs and histologic pattern can be combined to identify groups of patients with a very poor prognosis, which could benefit from a more aggressive therapy. Indeed, in 116 multiple myelomas, treated with conventional chemotherapy, no patient with G3 histology, diffuse infiltration, high tumor burden and high AgNOR counts survived at 4 year follow-up, and in 65 prostate carcinomas, treated with hormonal therapy alone, no patient with G3 histology and high AgNOR counts survived after 4 years. In 40 adult patients with acute myelogeneous leukemias, all treated with EORTC protocol, those with low AgNOR counts had a low response to conventional chemotherapy and a short survival: this would support the indication to perform bone marrow transplantation in these patients. Finally, 21 patients with renal cell carcinoma and a median AgNOR counts of 5.94, as previously reported (Pich et al. Pathol Res Pract 187, 482-486, 1991), were subsequently followed for 6 years: all the patients with less than 5.94 AgNOR/cell were alive at the end of the observation. Our results clearly indicate that the evaluation of AgNOR proteins has a strong prognostic relevance not only in retrospective, but also in prospective studies.
Prognostic relevance of the AgNOR proteins in tumor pathology
PICH, Achille;
1998-01-01
Abstract
AgNOR expression was analysed in pharyngeal carcinoma, multiple myeloma, thymoma, male breast cancer, prostate carcinoma, renal cell carcinoma and adult acute myelogeneous leukemia. In all these tumors, AgNOR counts showed a strong prognostic significance and appeared as an independent variable in the Cox multivariate analysis. In addition, AgNORs and histologic pattern can be combined to identify groups of patients with a very poor prognosis, which could benefit from a more aggressive therapy. Indeed, in 116 multiple myelomas, treated with conventional chemotherapy, no patient with G3 histology, diffuse infiltration, high tumor burden and high AgNOR counts survived at 4 year follow-up, and in 65 prostate carcinomas, treated with hormonal therapy alone, no patient with G3 histology and high AgNOR counts survived after 4 years. In 40 adult patients with acute myelogeneous leukemias, all treated with EORTC protocol, those with low AgNOR counts had a low response to conventional chemotherapy and a short survival: this would support the indication to perform bone marrow transplantation in these patients. Finally, 21 patients with renal cell carcinoma and a median AgNOR counts of 5.94, as previously reported (Pich et al. Pathol Res Pract 187, 482-486, 1991), were subsequently followed for 6 years: all the patients with less than 5.94 AgNOR/cell were alive at the end of the observation. Our results clearly indicate that the evaluation of AgNOR proteins has a strong prognostic relevance not only in retrospective, but also in prospective studies.
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