Cheville J C, Clamon G H, Robinson R A
Department of Pathology, College of Medicine, University of Iowa Hospitals and Clinics, Iowa City.
Mod Pathol. 1990 Sep;3(5):596-8.
Nucleolar organizer regions (NORs) are loops of chromosomal DNA that ultimately direct the development of the nucleolus. These NORs are associated with argyrophilic acidic nonhistone proteins which have allowed the demonstration of NORs by a simple silver stain. This staining technique has been used to examine the number of silver-stained NORs (AgNORs) in malignant and benign conditions, and, in general, AgNOR numbers are increased in malignant tissues when compared with normal or benign conditions. More recently, this technique has been applied to premalignant lesions with varying results. We applied this silver stain to prostate lesions where nucleolar features are of diagnostic importance. The stain was applied to ten cases of prostatic hyperplasia, ten cases each of prostatic intraepithelial neoplasia (PIN) grades 1 through 3, and ten cases each of low grade, intermediate grade, and high grade adenocarcinoma. The counting was performed by image analysis. A significant mean difference did exist between low grade and the two higher grades of adenocarcinoma. There was no significant difference in AgNOR counts per nucleus in hyperplasia, PIN, or adenocarcinoma or between the three grades of PIN. The AgNOR silver stain is not useful in the differentiation of hyperplasia, the three grades of PIN, and adenocarcinoma. Also because of overlap among the three grades of adenocarcinoma, it is not useful in the differentiation of these lesions.
核仁组织区（NORs）是染色体DNA的环状结构，最终指导核仁的形成。这些NORs与嗜银酸性非组蛋白相关，这使得通过简单的银染就能显示NORs。这种染色技术已被用于检查恶性和良性病变中银染NORs（AgNORs）的数量，一般来说，与正常或良性病变相比，恶性组织中的AgNOR数量会增加。最近，这项技术已应用于癌前病变，结果各异。我们将这种银染应用于核仁特征具有诊断重要性的前列腺病变。该染色应用于10例前列腺增生、10例1至3级前列腺上皮内瘤变（PIN）以及10例低级别、中级别和高级别腺癌。通过图像分析进行计数。低级别腺癌与两个较高级别腺癌之间确实存在显著的平均差异。增生、PIN或腺癌中每个细胞核的AgNOR计数，或PIN的三个级别之间均无显著差异。AgNOR银染在区分增生、PIN的三个级别和腺癌方面并无用处。此外，由于腺癌的三个级别之间存在重叠，它在区分这些病变方面也无用处。
