Nucleolar organizer region count and subjective AgNOR pattern assessment (SAPA) score in skin tumors

AgNOR Pleomorphic Count as a Tumor Marker in Cervical Carcinogenesis and Feasibility of Its Introduction in Cervical Cancer Screening Programs to Discriminate High-Risk Cases of Squamous Intraepithelial Lesions of the Cervix

BACKGROUND

AgNOR pleomorphism has been widely used for its diagnostic importance in differentiating premalignant and malignant lesions of different human neoplasms. However, an evaluation of its potential for discriminating cases of high-risk squamous intraepithelial lesions of the cervix (SIL) has been rarely attempted.

AIM

The tumor marker potential of AgNOR pleomorphism counts was assessed by correlating high and low mean counts in low-grade SIL (LSIL) cases with persistence or regression of the lesion and HPV positivity.

MATERIALS AND METHODS

The 115 LSIL cases selected for the study were registered from the ongoing cervical cancer screening of the rural population of Lucknow West. Silver nitrate staining for AgNOR counts and HPV DNA testing were done in all 115 cases.

RESULTS

The AgNOR counts in the 115 LSIL cases revealed low counts in 92 and high counts in 23 cases. Follow-up, available in 107 cases, revealed persistence of the lesion in 21 of the 23 cases with high counts and in 4 of the 84 cases with low counts. HPV positivity showed a strong correlation with high counts. Persistence of LSIL was also more frequent with high AgNOR counts and in HPV-positive cases.

CONCLUSIONS

The study showed a correlation of high mean AgNOR counts with HPV positivity and persistence of LSIL.

Diagnostic importance of AgNOR pleomorphism in cervical carcinogenesis

Objective:

Nucleolar organizer region (NOR) associated proteins are argyrophilic and visualized by silver stains. AgNOR pleomorphic dots increase in cancer and most researchers have done a common count of single dots. Pleomorphic dots are few and perhaps indicate a more severe prognosis. The present study was aimed at investigating the relative preponderance and diagnostic value of both pleomorphic and single AgNOR dots in cervical carcinogenesis.

Study design:

Silver nitrate staining was performed in 50 cervical smears each of cytologically diagnosed normal, inflammatory, low grade squamous intraepithelial lesion (LSIL), High-grade squamous intraepithelial lesion (HSIL), and squamous cell carcinoma cases registered at C.S.M. Medical University, Lucknow, India.

Results:

The accumulated data revealed a positive and significant correlation of cell counts of both pleomorphic (r = 0.94; p < 0.01) and single dots (r = 0.95; p < 0.01) with disease severity. The rate of increase in cell counts of pleomorphic dots (β = 2.61) was 1.1 times higher than the rate of increase in cell counts of single dots (β = 2.29).

Conclusion:

This study indicates the diagnostic potential of pleomorphic dots in the process of cervical carcinogenesis. The number of pleomorphic dots also varies significantly in different types of SIL, which may help in discriminating precancerous lesions of the cervix.

Silver-stained nucleolar organizer regions and immunoglobulins in cutaneous squamocellular tumors

This study was conducted to elucidate the biological activity of epidermal cells in cutaneous squamocellular tumors by counting the number of silver-stained nucleolar organizer regions (AgNORs), to estimate the quantity of Ig-producing cells and the inflammatory cellular infiltrate (ICI), and to achieve a comparative evaluation. Twenty cases of actinic keratosis (AK), 20 in situ squamous cell carcinomas (ISC), and 20 invasive squamous cell carcinomas (SCCs) were assessed using a silver colloid technique. Ig-producing or binding cells and ICI were also investigated immunohistochemically. In all samples, AgNORs, Ig-producing cells, and ICI increased in proportion to the degree of malignancy. With regard to AgNORs values, a statistically significant difference was confirmed between AK and ISC (p<0.01), AK and SCC (p<0.001), and ISC and SCC (p<0.05). IgG-producing cells predominated in each case. Furthermore, a linear correlation was detected between ICI and AgNORs in AK and ISC. The significant difference in the number of AgNORs among the 3 stages of involution of SCC reinforces the value of AgNORs as a marker for malignant potential. Despite the absence of a correlation between AgNORs and the proportion of Ig-producing cells, the association between ICI and AgNORs in AK and ISC was obvious.

Value of Silver Binding Nucleolar Organiser Regions (AgNOR) in Squamous Cell Carcinomas of Upper Aero-digestive Tract

BACKGROUND

Study of Silver-binding nucleolar organizing regions (AgNORs) in 50 cases of squamous cell carcinomas (SCC) of upper Aero-digestive tract was carried out with an aim of correlating AgNOR positivity with histological grade of tumour and evaluating value of AgNOR staining in predicting the progress of disease.

METHODS

Tissue sections of the cases were stained with 50 percent silver nitrate solution for AgNOR evaluation and the data analysed. All the sections were also stained with haematoxylin and eosin stain for tumour typing and grading.

RESULTS

In this study, the mean AgNOR (mAgNOR) score of normal squamous epithelium (50 cases) was 1.56 (range1.00-2.80), that of well differentiated squamous carcinoma (27 cases) was 3.29 (range 2.4-4.6), moderately differentiated squamous carcinoma (21 cases) was 4.29 (range 2.7-5.6) and of poorly differentiated squamous cell carcinoma (2 cases) was 5.21. The mAgNOR scores were statistically significant. Comparison of the percentage AgNOR (pAgNOR) scores between well differentiated and moderately differentiated carcinomas showed that all the pAgNOR values (1-9) were significant. However, pAgNOR 3 and pAgNOR 4 were most significant. Cut off values for pAgNOR score to differentiate between the various grades of squamous cell carcinomas could not be calculated due to lack of data on survival rates.

CONCLUSION

AgNOR technique can definitely be used as a supportive tool to routinely performed Hemotoxylin and Eosin staining and may help in prognosis as well as therapeutic decision-making in squamous cell carcinomas. Studies of larger number of cases in a prospective study are needed to arrive at more substantial conclusions.

Nucleolar organizer region staining patterns in paraffin-embedded tissue cells from human skin cancers

BACKGROUND

Increased number of nucleoli (nucleolar organizer regions, NORs) with abnormal shapes and sizes, including small dots, has been used as prognostic tools to evaluate tumor proliferation levels and troublesome borderline lesions. In this study, NOR patterns of skin cancers were performed in the search of a valuable prognostic method to complement other histological procedures.

METHODS

Paraffin-embedded tumor tissue was obtained from basal and squamous cell carcinomas, cutaneous malignant melanoma, premalignant lesions, and Skmel-28 human melanoma cells. Slices were dewaxed and AgNOR stained. The patterns were scored and submitted for statistical analyses.

RESULTS

All types of cancer cells showed variable numbers of abnormally shaped nucleoli and dot-like structures. Only tumor cells presented four or more nucleoli, with or without dots, while 85% of the normal cells had one single NOR without dots. Most data were statistically significant when compared to normal cells. As a whole, squamous cell carcinoma and malignant melanoma tumor cells had less NOR alterations than basal cell carcinoma (BCC) tumor types.

CONCLUSIONS

Changes in the number and shape of nucleoli present in malignant cells could be attributed to increased levels on rDNA transcription on cancer cells, besides abnormal remodeling of chromatin, which could disrupt proper nucleoli association. Increased genetic alterations on malignant basal cells could contribute to impair invasive and migration abilities of BCC tumors.

Immunohistochemical markers of melanocytic lesions: a review of their diagnostic usefulness

We critically reviewed recent literature reports of 25 melanocytic immunohistochemical markers. This review organizes and summarizes the many new studies of old and novel melanocytic markers and identifies the most promising diagnostic immunohistochemical markers that can be used to distinguish melanocytic from nonmelanocytic lesions and benign melanocytic from malignant melanocytic lesions.