Abstract
Introduction: Number of Argyrophillic Nucleolar Organizer Regions (AgNORs) is a good indicator of cellular proliferation activity and is useful diagnostic tool to estimate the malignant potential of tumors. Methods: Tissue sections from 40 cases of gall bladder disease, including 27 cases of gallbladder carcinoma and 13 cases of chronic cholecystitis, were studied for AgNORs count. The correlation of the AgNOR was carried out with various clinco-pathological parameters. Results: Mean AgNOR counts in gallbladder cancer (11.354 ± 1.7866) were significantly higher than chronic cholecystitis (2.0815 ± 0.3731). Amongst patients with gallbladder carcinoma, well-differentiated (9.5867 ± 1.8928), moderately-differentiated (11.1971 ± 1.3181) and poorly-differentiated adenocarcinoma (13.1829 ± 0.9779) showed statistically significant difference in AgNOR counts. On inter stage comparison, study revealed progressive and statistically significant increase in AgNOR count from Tis to T4 stage. Mean AgNOR count for GBCs without metastasis was lower (10.5186 ± 1.6911) than metastatic GBC (12.2538 ± 1.4581), difference being statistically significant (p=0.009). Discussion and conclusions: Our results demonstrate that AgNOR parameters are useful indicators to evaluate malignant behavior of gallbladder carcinoma and its combination with conventional cytology may increase the diagnostic accuracy. AgNOR index can be used as a rapid, inexpensive and easily performed diagnostic tool to aid in early confirmation of a suspicious case of malignant gallbladder disease.
Highlights
Number of Argyrophillic Nucleolar Organizer Regions (AgNORs) is a good indicator of cellular proliferation activity and is useful diagnostic tool to estimate the malignant potential of tumors
NORs can be demonstrated in tissue sections by staining their associated proteins with colloidal silver and these reaction products represent the Argyrophilic Nucleolar Organizer Regions (AgNORs) which appear as black dots of various sizes in the nucleolus and nucleus [4]
Its role is well-established in the diagnosis of lymphoma, breast cancer, prostatic tumors, oral cavity tumors and other tumors but there have been very few studies evaluating the role of AgNOR count in biliarytract malignancies in general and carcinoma gallbladder in particular
Summary
Number of Argyrophillic Nucleolar Organizer Regions (AgNORs) is a good indicator of cellular proliferation activity and is useful diagnostic tool to estimate the malignant potential of tumors. NORs are considered to be a marker of both DNA transcriptional activity and DNA transcriptional potential [3]. Associated with these regions are certain acidic and argyrophilic, non-histonic proteins called NOR-Associated Proteins (NORAPs). NORs can be demonstrated in tissue sections by staining their associated proteins with colloidal silver and these reaction products represent the Argyrophilic Nucleolar Organizer Regions (AgNORs) which appear as black dots of various sizes in the nucleolus and nucleus [4]. Its role is well-established in the diagnosis of lymphoma, breast cancer, prostatic tumors, oral cavity tumors and other tumors but there have been very few studies evaluating the role of AgNOR count in biliarytract malignancies in general and carcinoma gallbladder in particular
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