Irazusta S P, Vassallo J, Magna L A, Metze K, Trevisan M
Department of Pathology, Faculty of Medical Sciences, State University of Campinas, S.P., Brazil.
Pathol Res Pract. 1998;194(1):33-9. doi: 10.1016/s0344-0338(98)80009-5.
The aim of the present study was to examine the usefulness of the quantification of PC10-positive-cells and of Argyrophilic Nucleolar Organizer Regions (AgNORs) in gastric biopsies for the identification of gastric mucosal proliferative lesions. Fifty seven paraffin-embedded endoscopic biopsies were classified into four histologic groups: normal, inflammatory, dysplastic and neoplastic mucosa. The percentage of PC10-positive cells was determined by immunohistochemistry. The AgNOR parameters determined included the total number of all identifiable silver precipitations in the nucleus, the mean number of silver precipitations per cluster, and the presence of morphologically heterogenous silver precipitations. Group comparisons were performed using the Kruskall Wallis and Dunn non-parametric tests with a significance level of 5%. A discriminant analysis (followed by the jack-knife procedure) was performed using the three AgNOR parameters plus the percentage of PCNA-positive cells as the independent variables and histological groups as the dependent variable. All three AgNOR parameters, as well as the percentage of PCNA-stained nuclei, showed their highest values in the carcinoma group. However, no good differentiation among the four histologic groups was obtained using only one of these parameters, since there was always considerable overlap among them. By combining all the parameters in a linear discriminant analysis, we obtained a correct classification in 48 out of 57 cases. Within the classification errors there was only one false positive carcinoma, which was in fact a dysplasia and only one false negative carcinoma erroneously classified as dysplasia. The number of cells with heterogenous AgNORs was the most important parameter for the discriminant analysis. No correlation between PCNA values and the AgNOR parameters could be found, thus indicating that they do not represent the same phenomenon in the cell cycle. We concluded that the use of a combination of various proliferation parameters in a linear discriminant analysis may be helpful for differentiating gastric mucosal lesions. The peculiar AgNOR morphology is an important variable which should be taken in consideration in quantitative studies. PCNA and AgNORs seem to represent different physiological phenomena in the cell cycle.
本研究的目的是检测胃活检中PC10阳性细胞和嗜银核仁组成区（AgNORs）定量分析对胃黏膜增生性病变识别的有用性。57例石蜡包埋的内镜活检标本被分为四个组织学组：正常、炎症、发育异常和肿瘤性黏膜。通过免疫组织化学测定PC10阳性细胞的百分比。所测定的AgNOR参数包括细胞核中所有可识别银沉淀的总数、每簇银沉淀的平均数以及形态学上异质性银沉淀的存在情况。使用Kruskal Wallis和Dunn非参数检验进行组间比较，显著性水平为5%。使用三个AgNOR参数加上PCNA阳性细胞的百分比作为自变量，组织学组作为因变量进行判别分析（随后采用留一法）。所有三个AgNOR参数以及PCNA染色细胞核的百分比在癌组中均显示出最高值。然而，仅使用这些参数之一无法在四个组织学组之间获得良好的区分，因为它们之间总是存在相当大的重叠。通过在线性判别分析中组合所有参数，我们在57例病例中的48例中获得了正确分类。在分类错误中，只有一例假阳性癌，实际上是发育异常，只有一例假阴性癌被错误地分类为发育异常。具有异质性AgNORs的细胞数量是判别分析中最重要的参数。未发现PCNA值与AgNOR参数之间存在相关性，因此表明它们在细胞周期中不代表相同的现象。我们得出结论，在线性判别分析中使用多种增殖参数的组合可能有助于区分胃黏膜病变。独特的AgNOR形态是定量研究中应考虑的一个重要变量。PCNA和AgNORs似乎在细胞周期中代表不同的生理现象。
