Abstract
Objectives: Assessment of the cell proliferation rate in tissues can be one of the markers for impending malignancy in precancers. The state of activation and the proliferation activity of the cells can be assessed by the frequency of silver stained Nucleolar Organiser regions (AgNOR) within the nuclei which is significantly higher in malignant cells. The present study was carried out to analyze the distribution of the AgNOR in oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC), and in their various histological grades, and to assess if the AgNOR distribution could give information on the malignant potentiality in premalignant lesions and aggressiveness of the malignant lesions. Study design: The study specimens comprised of 35 archival cases, of which 15 cases were of OL and 20 cases of OSCC. The specimens were stained by hematoxylin and eosin and modified silver staining method of Ploton et al. for the Nucleolar Organiser Regions. The specimens were analyzed independently by the two observers and was further statistically analysed. Results: The mean AgNOR count in OL was 2.80 ±0.50 and in cases of OSCC was 5.71± 1.08. The mean AgNOR count in OL cases of mild dysplasia was 2.59 ±0.66, in moderate dysplasia was 2.92± 0.43 and in severe dysplasia was 2.79. The mean AgNOR count in cases of well differentiated OSCC was 5.73± 1.62 and in cases of moderately differentiated OSCC was 5.67±1.19. Conclusion: The mean AgNOR count was higher in cases of OSCC as compared to cases of OL, and the AgNOR counts increased with the increase in the grades of dysplasia indicating a higher proliferative rate with increase in dysplasia.
Highlights
Oral squamous cell carcinoma accounts for over 90% of oral cancer cases (1) and a small percentage of these cases are thought to develop from precancers like leukoplakia, lichen planus, oral submucous fibrosis etc
The present study comparatively assessed the difference in the cell proliferation rates in the various histological grades of oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC) by the al Diagnostic value of nucleolar organizer regions (AgNORs) technique
The mean AgNOR count was higher in the cases of OSCC as compared to cases of OL, with a statistically significant difference (p
Summary
Oral squamous cell carcinoma accounts for over 90% of oral cancer cases (1) and a small percentage of these cases are thought to develop from precancers like leukoplakia, lichen planus, oral submucous fibrosis etc. Several methods have been used for the identification of proliferating cells in tissue sections with the aim to use them as a marker for impending malignancy, one among them is Silver binding Nucleolar Organiser region (AgNOR) technique. This is a simple one step staining technique which overcomes the disadvantages of other techniques such as requirement of sophisticated equipment, technical expertise, cost and time consumption (2,3). Nucleolar Organiser Regions (NOR) are loops of DNA that encode ribosomal RNA and are considered important in the synthesis of protein (4). The objectives of the study were to analyze NOR related parameter in OL and its various histological grading and in OSCC and its various histological grading; and to assess the correlation in the difference between nucleolar organizer related parameters in OL and OSCC
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