Nucleolar organizer regions in exocrine pancreas in chronic pancreatitis and ductal adenocarcinoma. Diagnostic value and cytophysiologic correlate.

The epithelium of small excretory ducts of the pancreas was investigated in sections obtained from 33 total-pancreatectomy-specimens by means of AgNOR-silver-staining as described by Ploton [26], in some modification. AgNOR-staining was evaluated by automatic image analysis. Specimens were split into four groups: mucoid transformation in chronic pancreatitis (11 cases), papillary hyperplasia in chronic pancreatitis (eight cases), ductal adenocarcinoma (14 cases) and control-group of pancreas-transplants (five cases). Parameters estimated for each cell are as follows: number of intranucleolar dots, number of extranucleolar dots, total number of dots, ratio of extra- and intranucleolar dots, total dot area, mean single dot area, nuclear area, ratio of total dot- and nuclear area, dot-density. Ratio of extra- and intranucleolar dots, ratio of total dot- and nuclear area as well as dot-density allowed differentiation between papillary hyperplasia in chronic pancreatitis, grade III, and ductal adenocarcinoma, grade I. A correlation was found between the number of extranucleolar dots and proliferative activity as well as between the number of intranucleolar dots and protein-synthesis activity of epithelial cells of small excretory ducts of the pancreas.