title: Silver-stained nucleolar organizer regions in normal and dysplastic cervical lesions: correlation with DNA ploidy and S-phase fraction by flow cytometry.
abstract: OBJECTIVE
  To investigate the prognostic significance of DNA ploidy and silver-stained nucleolar organizer regions (AgNOR), their relation to the cytological grades of cervical dysplasia and correlation of cells in the S-phase of the cell cycle and DNA ploidy with AgNOR count.
  
  
  METHODS
  Multiparametric DNA flow-cytometric analysis and AgNOR count were performed on cervical smear samples, cytologically diagnosed as normal (n = 196), atypical squamous cells of unknown significance (ASCUS, n = 98) and various grades of cervical dysplasia (n = 127).
  
  
  RESULTS
  Among the cytological grade, aneuploid cases from low-grade squamous intraepithelial lesion (mild) and high-grade squamous intraepithelial lesion (moderate and severe) groups were showing high AgNOR counts (ranges 4.33-5.86 and 5.91-7.42, respectively). Aneuploid cases from the ASCUS group also presented high AgNOR (range 3.72-4.93). The high percentage of cells in the S-phase (>12%) correlated with these 2 parameters in the ASCUS and dysplasia groups. After grouping the cases into those with high (>4.0) and low (<4.0) AgNOR counts, significant correlations in the group with high AgNOR count with DNA ploidy, S-phase and cytological grade were recorded (p < 0.001). Results obtained from follow-up study revealed that cases with aneuploidy, high AgNOR count and S-phase fraction presented with a progressive trend of disease.
  
  
  CONCLUSIONS
  Thus, the study shows that high AgNOR count, S-phase fraction and aneuploid DNA have prognostic significance in the early detection of cervical cancer.
authors.affiliation: Industrial Toxicology Research Center, Queen Mary's Hospital, King George's Medical University, Lucknow, India.
authors.forename: Madhulika
authors.initials: M
authors.lastname: Singh
authors.forename: Sahdeo
authors.initials: S
authors.lastname: Prasad
authors.forename: Neetu
authors.initials: N
authors.lastname: Kalra
authors.forename: Uma
authors.initials: U
authors.lastname: Singh
authors.forename: Yogeshwer
authors.initials: Y
authors.lastname: Shukla
mesh_terms: D000328:Adult; D000368:Aged; D034961:Antigens, Nuclear / Q000032:analysis; D002452:Cell Count; D002584:Cervix Uteri / Q000473:pathology; D004247:DNA / Q000235:genetics*; D004273:DNA, Neoplasm / Q000235:genetics*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008875:Middle Aged; D009687:Nuclear Proteins / Q000032:analysis; D009697:Nucleolus Organizer Region / Q000473:pathology*; D011003:Ploidies; D011379:Prognosis; D016196:S Phase; D016622:Silver Staining; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014626:Vaginal Smears