Diagnostic and Prognostic Significance of AgNOR Counts in Before and After Radiotherapy-Treated Cervical Carcinogenesis is Compared with Cervical Cytology and Histology

Abstract

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.