title: Evaluation of the argyrophilic nucleolar organizer region, nuclear DNA content and mean nuclear area in transitional cell carcinoma of bladder using a quantitative image analyzer.
abstract: To search for reliable parameters that reflect the biological potential of bladder cancer, the argyrophilic nucleolar organizer region (AgNOR), nuclear DNA content and mean nuclear area (MNA) were studied in paraffin-embedded materials of 75 primary transitional cell carcinomas (TCCs) using a quantitative image analyzer, and were also compared with histological findings and prognosis. The AgNOR parameters studied were the mean AgNOR count (C-AgNOR) and the percentage of cells exhibiting more than 4 AgNOR dots within nuclei (P-AgNOR), whereas the DNA parameters were the 2c deviation index (2cDI) and 5c exceeding rate (5cER). These 5 parameters significantly correlated with the histological grade (p < 0.0001, respectively). Similarly, these 5 parameters correlated with the histological stage, but the correlation was higher in 2cDI and 5cER (p < 0.0001, respectively) in comparison with the AgNOR parameters and MNA. Using univariate analysis, the prognostic relevance was noted in all but P-AgNOR. The 5cER value could discriminate histological grade-II tumors in relation to prognosis, whereas the remaining parameters could not. In addition, the significant difference between noninvasive and invasive tumors was noted in 2cDI and 5cER (p < 0.05, respectively), but not in C-AgNOR, P-AgNOR and MNA. These results suggest that (i) 2cDI and 5cER exhibit superiority over the AgNOR parameters and MNA in predicting survival, and (ii) in histological grade-II tumors, evaluation of the 5cER value is most important when predicting survival as well as judging the necessity for further aggressive treatment in patients with TCCs of the bladder.
authors.affiliation: Department of Urology, Shimane Medical University, Izumo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Shiina
authors.forename: S
authors.initials: S
authors.lastname: Urakami
authors.forename: H
authors.initials: H
authors.lastname: Shirakawa
authors.forename: K
authors.initials: K
authors.lastname: Shigeno
authors.forename: Y
authors.initials: Y
authors.lastname: Himeno
authors.forename: M
authors.initials: M
authors.lastname: Mizutani
authors.forename: M
authors.initials: M
authors.lastname: Igawa
authors.forename: T
authors.initials: T
authors.lastname: Ishibe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D002467:Cell Nucleus / Q000473:pathology; D048429:Cell Size; D017024:Chemotherapy, Adjuvant; D015653:Cystectomy; D004273:DNA, Neoplasm / Q000032:analysis*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008875:Middle Aged; D008940:Mitotic Index; D009367:Neoplasm Staging; D009697:Nucleolus Organizer Region / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D016622:Silver Staining; D001749:Urinary Bladder Neoplasms / Q000235:genetics / Q000473:pathology* / Q000628:therapy
chemical_list: D004273:DNA, Neoplasm