Agarwal P K, Mehrotra A, Chandra T
Department of Pathology, King George's Medical College, Lucknow, India.
Indian J Exp Biol. 1995 Oct;33(10):715-20.
The present study is planned to assess the diagnostic relevance of silver stained nucleolar organizer regions (NORs) in discriminating benign from malignant lesions of the breast and to ascertain the interobserver variability in the enumeration of AgNOR counts. Forty four specimens of benign and malignant breast tissues were studied and mean number of silver stained nucleolar organizer regions (MNORA) have been counted in paraffin sections. Malignant lesions have a higher number of MNORA than benign lesions. These results also showed correlation between the AgNOR counts and size of the tumor, axillary lymph node status and age of the patient. Our results also indicate a close agreement between the two observers with limits of agreement. However, AgNOR counts are of little diagnostic importance since a broad zone of overlap exists between benign and malignant breast diseases despite significant higher mean counts in malignant lesions. AgNOR sequence could perhaps be of use to differentiate those two histological indistinguishable lesions. The tumor size and axillary lymph node involvement suggested to its prognostic significance also. Interobserver agreement further suggests the utility of AgNOR counts as diagnostic or prognostic discriminants in breast malignancies.
本研究旨在评估银染核仁组织区（NORs）在鉴别乳腺良恶性病变中的诊断相关性，并确定观察者间在AgNOR计数方面的变异性。对44例乳腺良恶性组织标本进行了研究，并在石蜡切片中计数了银染核仁组织区的平均数量（MNORA）。恶性病变的MNORA数量高于良性病变。这些结果还显示AgNOR计数与肿瘤大小、腋窝淋巴结状态及患者年龄之间存在相关性。我们的结果还表明，两位观察者之间的一致性较好，且一致性界限明确。然而，AgNOR计数的诊断价值不大，因为尽管恶性病变的平均计数显著高于良性病变，但乳腺良恶性疾病之间存在广泛的重叠区域。AgNOR序列或许可用于区分这两种组织学上难以区分的病变。肿瘤大小和腋窝淋巴结受累情况对其预后意义也有提示作用。观察者间的一致性进一步表明AgNOR计数在乳腺恶性肿瘤中作为诊断或预后判别指标的实用性。
