Pich A, Chiusa L, Margaria E
Department of Biomedical Sciences and Human Oncology, University of Turin, Italy.
Cancer Detect Prev. 1995;19(3):282-91.
The expression of the argyrophilic nucleolar organizer regions (AgNORs) has been analyzed in renal, bladder, and pharyngeal carcinomas, multiple myeloma (MM), and skin melanocytic lesions to clarify their role in tumor detection and prognosis. Sections from formalin-fixed, paraffin-embedded biopsies were stained with the method of Ploton; the mean AgNOR number per nucleus (AgNOR count) and their distribution (configuration) were assessed examining 100 neoplastic cells. AgNOR counts and histologic grade were highly associated in bladder urotheliomas (6.01 for grade 1 [G1], 7.69 for G2, 13.35 for G3; p < 0.00001) and MM (3.18 for G1, 4.36 for G2, 6.13 for G3; p < 0.0001); they were not associated in renal cell carcinomas (5.35 for G1, 5.92 for G2, 7.99 for G3; p = 0.132) and pharyngeal carcinomas (11.1 for G2, 10.27 for G3; p = 0.08). AgNOR number was also related to the degree of malignancy in melanocytic lesions (2.93 for common blue nevus, 2.89 for benign nevus [BN], 3.69 for cellular blue nevus [CBN], 7.71 for malignant melanoma, and 8.33 for malignant cellular blue nevus [MCBN]; p < 0.00001). Association between AgNOR counts and pathologic stage was found in bladder carcinomas (6.43 for pTa, 10.19 for pT1, 12.57 for pT2-4; p < 0.00001) and MM (3.06 for cases with percentage of bone marrow plasma cells [BMPC%] < or = 20, 4.28 for BMPC% 21 to 50, 5.14 for BMPC% > 50; p < 0.0001]; no correlation was found in pharyngeal (11.18 for T1, 10.08 for T2, 10.68 for T3, 11.47 for T4; p = 0.18) or renal cell carcinomas (6.06 for pT2, 6.31 for pT3; p = 0.78). Few, large and grouped AgNORs were found in well-differentiated bladder carcinomas, MM, and benign melanocytic lesions; numerous, small and dispersed AgNORs were seen in poorly differentiated bladder, renal and pharyngeal carcinomas, MM and malignant melanocytic lesions. Significant association with prognosis was found in pharyngeal carcinomas (5-year survival: 68% for cases with < or = 10.31 AgNOR/cell, 20% for cases with > 10.31 AgNORs) and MM (5-year survival: 46% for cases with < or = 4.62 AgNOR/cell, 7% for cases with > 4.62 AgNORs; in MM the configuration too was related to prognosis: median of survival 72 months for tightly grouped, 16 for partially grouped, and 11 for dispersed AgNORs). Our results indicate that AgNOR number and configuration are useful in detection and prognosis of some neoplasias. They permit a rapid evaluation of morphology and tumor cell kinetics even on small biopsies.(ABSTRACT TRUNCATED AT 400 WORDS)
为阐明嗜银核仁组织区（AgNORs）在肿瘤检测和预后中的作用，对肾癌、膀胱癌、咽癌、多发性骨髓瘤（MM）及皮肤黑素细胞病变中的AgNORs表达进行了分析。采用Ploton法对福尔马林固定、石蜡包埋活检组织切片进行染色；通过检查100个肿瘤细胞评估每个细胞核的平均AgNOR数量（AgNOR计数）及其分布（形态）。AgNOR计数与组织学分级在膀胱尿路上皮瘤（1级[G1]为6.01，G2为7.69，G3为13.35；p<0.00001）和MM（G1为3.18，G2为4.36，G3为6.13；p<0.0001）中高度相关；在肾细胞癌（G1为5.35，G2为5.92，G3为7.99；p = 0.132）和咽癌（G2为11.1，G3为10.27；p = 0.08）中无相关性。AgNOR数量也与黑素细胞病变的恶性程度相关（普通蓝痣为2.93，良性痣[BN]为2.89，细胞性蓝痣[CBN]为3.69，恶性黑色素瘤为7.71，恶性细胞性蓝痣[MCBN]为8.33；p<0.00001）。AgNOR计数与病理分期在膀胱癌（pTa为6.43，pT1为10.19，pT2 - 4为12.57；p<0.00001）和MM（骨髓浆细胞百分比[BMPC%]<或=20的病例为3.06，BMPC%为21至50的病例为4.28，BMPC%>50的病例为5.14；p<0.0001）中存在相关性；在咽癌（T1为11.18，T2为10.08，T3为10.68，T4为11.47；p = 0.18）或肾细胞癌（pT2为6.06，pT3为6.31；p = 0.78）中未发现相关性。在高分化膀胱癌、MM和良性黑素细胞病变中发现少量、大且成簇的AgNORs；在低分化膀胱癌、肾癌、咽癌、MM和恶性黑素细胞病变中可见大量、小且分散的AgNORs。在咽癌（5年生存率：AgNOR/细胞<或=10.31的病例为68%，AgNORs>10.31的病例为20%）和MM（5年生存率：AgNOR/细胞<或=4.62的病例为46%，AgNORs>4.62的病例为7%；在MM中形态也与预后相关：紧密成簇的AgNORs生存中位数为72个月，部分成簇的为16个月，分散的为11个月）中发现与预后有显著相关性。我们的结果表明，AgNOR数量和形态在某些肿瘤的检测和预后中有用。即使在小活检组织上，它们也能快速评估形态和肿瘤细胞动力学。（摘要截于400字）
