Argyrophilic nucleolar organizer regions: Their value and correlation with clinical prognostic factors in breast carcinoma

Abstract

Background and Objectives: Argyrophilic nucleolar organizer regions (AgNORs) have been recently identified as a marker of proliferative index in various tumors. These were evaluated in 46 patients with primary breast carcinoma and were correlated with clinical prognostic parameters of breast cancer. Ten patients with benign breast tumors served as controls in the study. Methods: AgNORs were stained in paraffin sections of the tissues using Ploton's silver technique. For each specimen, the number of AgNORs within the nuclei of 100 tumor cells were calculated. The average number of AgNORs per nucleus was calculated and the results expressed as mean ± S.D. Results: AgNOR count was significantly higher in breast carcinoma (6.61 ± 1.75) than in benign breast tumors (1.88 ± 0. 19). Further, the AgNOR count in breast carcinoma showed a statistically significant increase in correlation with the increase in the size of the tumor, stage of the cancer, number of metastatic lymph nodes, and tumor recurrence at various sites. However, the differences in AgNOR count at different lymph node levels and histologic grading were not statistically significant. Conclusions: These results indicate that breast tumors with a higher AgNOR count, even at the initial stage, have a poor prognosis and require aggressive treatment for better control of the disease. Further, it is suggested that the patients with a benign tumor and more than three AgNORs per nucleus need careful surveillance.