Argyrophilic nucleolar organiser regions in transitional cell bladder tumours related to established prognostic factors, progression and independent prognostic value.

Paraffin-embedded archival biopsy specimens from 229 primary transitional cell carcinomas (TCCs) were stained with silver nitrate to demonstrate the nucleolar organiser regions (Ag-NORs). T3-T4 high grade tumours had higher Ag-NOR counts/nucleus than low grade superficial papillary tumours (p less than 0.001). Non-papillary tumours showed more Ag-NORs than papillary ones (p less than 0.001). Aneuploid tumours with high S phase fraction had more Ag-NORs than diploid tumours (p less than 0.001) and mitotic frequency was also related significantly to Ag-NOR count (p less than 0.001). SD of nuclear area and nuclear area as measured by planar morphometry correlated significantly to Ag-NOR count (p less than 0.001). Close to 60% of the total number of Ag-NORs/nucleus can be related to other quantitative variables. Ag-NORs predicted independently survival in Ta-T1 tumours (p = 0.016) whereas in the whole series Ag-NORs had no independent prognostic value.