Diagnostic and Prognostic Significance of AgNOR Counts in Before and After Radiotherapy-Treated Cervical Carcinogenesis is Compared with Cervical Cytology and Histology
Tóm tắt
Nucleolar organizer region-associated proteins are argyrophilic and visualized by silver stains. There are two types of dots are present. One is the presence of single dots, and another is pleomorphic dots. Pleomorphic dots are few, increase with severity of cervical lesions and hence indicate a more severe prognosis. The present study aimed at investigating the diagnostic value of both pleomorphic and single AgNOR dots in cervical carcinogenesis in different cytological stages of cervix before and after radiotherapy. The results were correlated with cervical cytology and histopathology. The study was conducted on the samples of 37 untreated cases of patients coming to the outpatient door of AHRCC. In two slides, samples were taken for PAP smear cytology and AgNOR staining. From histopathological detection, various grades of squamous cell carcinoma of the cervix were determined. Samples were divided into cytological/histological normal/controls (N = 10), inflammation (N = 7), LSIL (N = 8), HSIL (N = 7) and invasive carcinoma (N = 5). AgNOR staining was performed slides containing cervical smears. Samples from same patients [LSIL (N = 8), HSIL (N = 7) and invasive carcinoma (N = 5)] that were subjected to radiotherapy were assessed again for AgNOR scoring. The rate of increase in cell counts of pleomorphic dots was higher than the rate of increase in cell counts of single dots, and there is a positive and significant correlation of cell counts of both pleomorphic and single dots with disease severity. The results were correlated with PAP stained cervical cytology and histopathology to find out the diagnostic and prognostic significance. In squamous cells of the normal/control group, the AgNORs were fine and centrally placed in the nucleoli. AgNORs in the case of LSIL, HSIL and invasive carcinoma of the cervix before radiotherapy were large and variable in size and shape. The cases studied for AgNORs count after 6 month of radiotherapy showed less number of AgNORs dots which were single and fewer in numbers as compared to the pre-radiation group. AgNOR pleomorphic dot counts increase with severity of cervical lesions and may be used as an effective tool along with cervical cytology and histopathology for detection of cervical carcinogenesis.
Tài liệu tham khảo
Misra JS, et al. AgNOR counts in cervical smears under normal and other cytopathologic conditions. Anal Quant Cytol Histol. 1982;27(6):337–40.
Motherby H, Nadjari B, et al. Diagnostic accuracy of effusion cytology. Diagn Cytopathol. 1999;20:350–7.
Derenzini M, Trerè D, et al. Nucleolar size indicates the rapidity of cell proliferation in cancer tissues. J Pathol. 2000;191(2):181–6.
Srivastava AN, et al. Diagnostic importance of AgNOR pleomorphism in cervical carcinogenesis AgNOR counts are useful in cervical smears. Diagn Cytopathol. 2013;8(3):208–10. https://doi.org/10.1002/dc.2840080304.
Darne JF, Polacarz SV, Sheridan E, Anderson D, Ginsberg R, Sharp F. Nucleolar organiser regions in adenocarcinoma in situ and invasive adenocarcinoma of the cervix. J Clin Pathol. 1990;43(8):657–60. https://doi.org/10.1136/jcp.43.8.657.
Fiorella RM, Saran B, Kragel PJ. AgNOR counts as a discriminator of lesions of the endocervix. Acta Cytol. 1994;38(4):527–30.
Srivastava AN, Misra JS, et al. AgNOR pleomorphic count as a tumor marker in cervical carcinogenesis and feasibility of its introduction in cervical cancer screening programs to discriminate high-risk cases of squamous intraepithelial lesions of the cervix. Acta Cytol. 2019;63:371–8. https://doi.org/10.1159/000498978.
Sheridan E, Anderson D, Ginsberg R, Sharp F. Nucleolar organiser regions in adenocarcinoma in situ and invasive adenocarcinoma of the cervix. J Clin Pathol. 1990;43(8):657–60.
Goyal R, et al. AgNOR counts are useful in cervical smears. Diagn Cytopathol. 1992;8(3):208–10.
Suresh UR, Chawner L, Buckley H, et al. Do AgNOR counts reflect cellular ploidy or cellular proliferation? J Pathol. 1990;160:213–5.
Prathiba D, Kuruvilla S. Value of AgNOR in premalignant and malignant lesions of the cervix. Ind J Pathol Microbiol. 1995;38:11–6.
Crocker J, Egan JM. Nucleolar organizer regions in pathology. Br J Cancer. 1992;65:1–7.
Chiu K, Joke L, Long K. Improved silver technique for showing nucleolar organizer region in paraffin wax section. J Clin Pathol. 1989;42:992–4.
Yang P, Hang GS, Zhu XS. Role of nucleolar organizer regions in differentiating malignant from benign tumours of the colon. J Clin Pathol. 1990;43:235–8.
Lakshmi S, Nair SA, Jayashree R, et al. Argyrophilic nucleolar organizer region (AgNOR) in inflammatory, premalignant and malignant lesions of the uterine cervix. Cancer Lett. 2007;71:197–201.
Kinoshita Y, Dohi M, Mizutoni N, et al. Effects of preoperative radiation and chemotherapy on AgNOR counts in oral squamous cell carcinoma. J Oral Maxillofac Surg. 1993;54:304–7.
Miller B, Flex S, Docker M. NOR’s in cancers of uterine cervix. Cancer. 1974;74:3142–5.
Agarwal J, Gupta JK. NOR’s in neoplastic and non-neoplastic epithelium of the cervix. Ind J Pathol. 1997;40:125–7.