Shimazui T, Tomobe M, Hattori K, Uchida K, Akaza H, Koiso K
Department of Urology, University of Tsukuba, Ibaraki, Japan.
J Urol. 1995 Oct;154(4):1522-6.
Evaluation of prognostic significance of nucleolar organizer regions (NORs) in renal cell carcinoma (RCC).
Nuclear organizer regions were quantified in a series of 59 cases of RCC by the silver colloid method, and the NOR index was obtained from the ratio between mean NOR counts in each neoplastic nucleus and in normal nucleus. The patients were staged pathologically and divided into 2 groups by average NOR index of all cases, which was 0.76. Correlations between the NOR index and other parameters were statistically analyzed, and the prognostic value of the NOR index was also examined.
The NOR indices from each group were correlated with the survival curve. In low stage tumors (pT1 or 2 N0M0), the low NOR index group had a survival rate of almost 100 per cent while in those patients with higher NOR indices, there was a significantly increased mortality (p < 0.01). In patients presenting with high stage tumors (excluding pT1 and 2 N0M0), the survival rate was significantly improved in those patients with a low NOR index (p < 0.01). On the other hand, the patients with a low NOR index have a better prognosis than those with a high NOR index within each tumor grade (p < 0.01). Statistical analysis by the log rank test indicated NORs to be a significant predictor of survival over the whole series within low and high pathological stages and within each tumor grade. Analysis of the data with Cox's proportional hazard model showed that NOR index had a stronger hazard ratio than grade or stage of tumor (p = 0.0005).
Our study has demonstrated that NOR index is a new prognostic indicator for patients with RCC (p = 0.0005).
评估核仁组织区（NORs）在肾细胞癌（RCC）中的预后意义。
采用银胶体法对59例RCC病例的核仁组织区进行定量分析，通过计算每个肿瘤细胞核与正常细胞核平均NOR计数的比值得出NOR指数。对患者进行病理分期，并根据所有病例的平均NOR指数（为0.76）将其分为两组。对NOR指数与其他参数之间的相关性进行统计学分析，并检验NOR指数的预后价值。
每组的NOR指数与生存曲线相关。在低分期肿瘤（pT1或2 N0M0）中，低NOR指数组的生存率几乎为100%，而NOR指数较高的患者死亡率显著增加（p < 0.01）。在高分期肿瘤患者（不包括pT1和2 N0M0）中，低NOR指数患者的生存率显著提高（p < 0.01）。另一方面，在每个肿瘤分级内，低NOR指数患者的预后优于高NOR指数患者（p < 0.01）。对数秩检验的统计分析表明，在低、高病理分期以及每个肿瘤分级内，NORs是整个系列生存的重要预测指标。用Cox比例风险模型分析数据显示，NOR指数的风险比高于肿瘤分级或分期（p = 0.0005）。
我们的研究表明，NOR指数是RCC患者的一个新的预后指标（p = 0.0005）。
