The AgNORs count in predicting long-term survival in serous ovarian cancer.
BACKGROUND
The value of argyrophilic nucleolar organizer regions (AgNORs) to predict survival in patients with ovarian cancer has not been clearly explained yet. The aim of study was to assess the value of analysis of the mean number of AgNORs per nucleus (mAgNOR) and mean percentage of nuclei with five or more AgNORs per nucleus (pAgNOR) in the prediction of disease-free survival (DFS) and overall survival (OS) in patients with serous ovarian cancer.


METHODS
The study examined 52 patients treated for serous ovarian cancer with a follow-up period of 2-143 months. After silver staining paraffin specimens from primary surgery, mAgNOR and pAgNOR in cancer cells were counted and analyzed. Age, grading, radicality of surgery and FIGO staging were analyzed as covariates.


RESULTS
Mean mAgNOR equaled 4.4 ±0.9 and pAgNOR equaled 42.2 ±20.8%. Both mAgNOR and pAgNOR were the lowest in G1 tumors. The mAgNOR and pAgNOR were lower in stage I than stage IV cancers. The DFS and OS rates were respectively 15.4% and 21.2%. In univariate analysis FIGO staging, grading, and pAgNOR were associated with worse prognosis, while radicality of surgery remained a significant protective factor in terms of DFS. Higher FIGO staging and older age worsened OS. In multivariate analysis FIGO staging remained significantly associated with both DFS (HR 1.98; 95% CI 1.05-3.71) and OS (HR 1.76; 95% CI 1.00-3.10), while age affected OS rates (HR 1.78; 95% CI 1.04-2.95).


CONCLUSIONS
mAgNOR and pAgNOR are useful markers of cellular kinetics. Prospective studies in larger populations are needed to confirm these results in terms of AgNORs' effects on survival.
Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland.
Leszek
L
Gottwald
Department of Nephropathology, Division of Morphometry, Medical University of Lodz, Poland.
Marian
M
Danilewicz
Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Poland.
Wojciech
W
Fendler
Department of Gynecology and Gynecologic Oncology, I Chair of Obstetrics and Gynecology, Medical University of Lodz, Poland.
Jacek
J
Suzin
Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland.
Michal
M
Spych
Department of Surgical Oncology, Chair of Oncology, Medical University of Lodz, Poland.
Janusz
J
Piekarski
Department of Gynecology and Gynecologic Oncology, I Chair of Obstetrics and Gynecology, Medical University of Lodz, Poland.
Wieslaw
W
Tylinski
Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland.
Justyna
J
Chalubinska
Department of Health Care Policy, Medical University of Lodz, Poland.
Katarzyna
K
Topczewska-Tylinska
Palliative Care Unit, Chair of Oncology, Medical University of Lodz, Poland.
Aleksandra
A
Cialkowska-Rysz
argyrophilic; nucleolar organizer regions; prognostic factors; serous ovarian cancer; survival