Muscara M, Giuffre G, Rossiello R, Sarnelli R, Barresi G, Tuccari G
Department of Human Pathology, University of Messina, Italy.
Pathol Res Pract. 1996 May;192(5):407-13. doi: 10.1016/S0344-0338(96)80001-X.
The amount and distribution of interphase argyrophilic nucleolar organizer regions (AgNORs) was studied in 51 gallbladder surgical specimens including 32 primary carcinomas, 10 adenomas and 9 cases of chronic cholecystitis with calculi. The mean nuclear AgNOR area (NORA) and the AgNOR distribution score (NORDS), i.e. the percentage of cells carrying nucleolar aggregates with more than 6 distinct silver dots, were evaluated in 200 epithelial nuclei per specimen by means of automated image analysis and direct counting respectively. Statistical analysis (variance analysis and Student-Neuman-Keuls' test) performed on the pooled mean AgNOR values showed a significant difference (p < 0.001) between carcinomas and non-carcinomatous lesions. Both NORA and NORDS highly discriminated carcinomas with histopathological grade 4 versus cases with grade 1, 2 or 3 (p < 0.001); a less statistically significative p value (< 0.05) was encountered when NORDS values of well differentiated grade 1 carcinomas and adenomas were compared. The NORA parameter permitted the discrimination of stage IV versus stage I carcinomas (p < 0.001), while carcinomas in stage IV and those in stage II were distinguished with a p < 0.05; the NORDS parameter allowed also to distinguish stage IV from both stage I or II tumours (p < 0.001). Our results indicate that the above-mentioned AgNOR parameters may be utilized as additional, more objective quantitative criteria in the clinical-pathological assessment of the outcome of gallbladder carcinomas.
对51份胆囊手术标本进行了研究，其中包括32例原发性癌、10例腺瘤和9例伴有结石的慢性胆囊炎。通过自动图像分析和直接计数，分别在每个标本的200个上皮细胞核中评估平均核嗜银核仁组织区（AgNOR）面积（NORA）和AgNOR分布评分（NORDS），即携带具有6个以上明显银点的核仁聚集物的细胞百分比。对汇总的平均AgNOR值进行的统计分析（方差分析和Student-Neuman-Keuls检验）显示，癌与非癌性病变之间存在显著差异（p < 0.001）。NORA和NORDS都能很好地区分组织病理学4级癌与1、2或3级病例（p < 0.001）；比较高分化1级癌和腺瘤的NORDS值时，p值的统计学意义较小（< 0.05）。NORA参数能够区分IV期癌与I期癌（p < 0.001），而IV期癌与II期癌的区分p值< 0.05；NORDS参数也能将IV期肿瘤与I期或II期肿瘤区分开来（p < 0.001）。我们的结果表明，上述AgNOR参数可作为胆囊癌临床病理评估结果中额外的、更客观的定量标准。
