title: Diagnostic and prognostic value of nucleolar organizer regions in normal epithelium, dysplasia, and squamous cell carcinoma of the oral cavity.
abstract: BACKGROUND
  Nucleolar organizer regions (AgNORs) are associated with proliferative activity and represent a diagnostic aid and prognostic marker in several neoplastic entities.
  
  
  METHODS
  Sections from 51 T1-2 squamous cell carcinomas (SCC), 20 cases of dysplasia, and 8 specimens with normal epithelium were evaluated by 2 AgNOR counting methods: 1) the mean number of AgNORs per nucleus (mAgNOR) and 2) the percentages of nuclei with > 1, > 2, > 3, and > 4 AgNORs (pAgNOR > 1, pAgNOR > 2, pAgNOR > 3, and pAgNOR > 4, respectively).
  
  
  RESULTS
  Both mAgNOR and pAgNOR counts enabled significant discrimination between normal epithelium and dysplasia (P < 0.0003) and between dysplasia and SCC (P < 0.0001). For SCC, no correlation was found between AgNOR counts and clinical classification. Univariate analysis using the log rank test showed that the overall means for mAgNOR and pAgNORs correlated with the disease free period and survival time (P < 0.0040). Patient age, gender, type of treatment, and T and N classification failed to predict the outcome. Multivariate analysis showed that pAgNOR > 1 (cutoff level of 88%) was the best discriminator regarding the disease free period and survival time (P = 0.0001 and P = 0.0076, respectively).
  
  
  CONCLUSIONS
  AgNOR enumeration, in particular pAgNOR > 1, appears to be a useful tool in distinguishing between normal epithelium, dysplasia, and SCC of the oral cavity. In this study, AgNOR counts were strong prognostic markers for patients with SCC.
authors.affiliation: Department of Otolaryngology, National Hospital, Oslo, Norway.
authors.forename: X
authors.initials: X
authors.lastname: Xie
authors.forename: O P
authors.initials: OP
authors.lastname: Clausen
authors.forename: J
authors.initials: J
authors.lastname: Sudbö
authors.forename: M
authors.initials: M
authors.lastname: Boysen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000235:genetics* / Q000532:radiotherapy / Q000601:surgery; D004396:Coloring Agents; D004273:DNA, Neoplasm; D018572:Disease-Free Survival; D004848:Epithelium / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000532:radiotherapy / Q000601:surgery; D009697:Nucleolus Organizer Region / Q000473:pathology*; D011379:Prognosis; D015203:Reproducibility of Results
chemical_list: D004396:Coloring Agents; D004273:DNA, Neoplasm