title: Gallbladder carcinoma: a video image analysis of AgNOR distribution and its relation to tumour stage and grade.
abstract: The amount and distribution of interphase argyrophilic nucleolar organizer regions (AgNORs) was studied in 51 gallbladder surgical specimens including 32 primary carcinomas, 10 adenomas and 9 cases of chronic cholecystitis with calculi. The mean nuclear AgNOR area (NORA) and the AgNOR distribution score (NORDS), i.e. the percentage of cells carrying nucleolar aggregates with more than 6 distinct silver dots, were evaluated in 200 epithelial nuclei per specimen by means of automated image analysis and direct counting respectively. Statistical analysis (variance analysis and Student-Neuman-Keuls' test) performed on the pooled mean AgNOR values showed a significant difference (p < 0.001) between carcinomas and non-carcinomatous lesions. Both NORA and NORDS highly discriminated carcinomas with histopathological grade 4 versus cases with grade 1, 2 or 3 (p < 0.001); a less statistically significative p value (< 0.05) was encountered when NORDS values of well differentiated grade 1 carcinomas and adenomas were compared. The NORA parameter permitted the discrimination of stage IV versus stage I carcinomas (p < 0.001), while carcinomas in stage IV and those in stage II were distinguished with a p < 0.05; the NORDS parameter allowed also to distinguish stage IV from both stage I or II tumours (p < 0.001). Our results indicate that the above-mentioned AgNOR parameters may be utilized as additional, more objective quantitative criteria in the clinical-pathological assessment of the outcome of gallbladder carcinomas.
authors.affiliation: Department of Human Pathology, University of Messina, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Muscara
authors.forename: G
authors.initials: G
authors.lastname: Giuffre
authors.forename: R
authors.initials: R
authors.lastname: Rossiello
authors.forename: R
authors.initials: R
authors.lastname: Sarnelli
authors.forename: G
authors.initials: G
authors.lastname: Barresi
authors.forename: G
authors.initials: G
authors.lastname: Tuccari
mesh_terms: D000236:Adenoma / Q000473:pathology; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology*; D002764:Cholecystitis / Q000473:pathology; D005706:Gallbladder Neoplasms / Q000473:pathology*; D006801:Humans; D018715:Microscopy, Video / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D009697:Nucleolus Organizer Region / Q000473:pathology*; D012834:Silver; D013194:Staining and Labeling / Q000379:methods; D019113:Telepathology / Q000379:methods
chemical_list: D012834:Silver