AgNOR Count in Cervical Swab Under Cytological Normal and Other Pathologic Conditions: A Tumour Prolifirative Marker
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ORIGINAL ARTICLE
AgNOR Count in Cervical Swab Under Cytological Normal and Other Pathologic Conditions: A Tumour Prolifirative Marker Gangotree Mohanty1
•
Ashok Kumar Padhy2
Received: 10 August 2020 / Revised: 18 September 2020 / Accepted: 12 October 2020 Ó Association of Gynecologic Oncologists of India 2020
Abstract Aim of Experiment To study the argyrophilic nucleolar organizer regions (AgNOR) as a cell proliferative marker in cervical smears and to assess its counts with the severity of the lesions on Papanicolaou (PAP)-stained cervical smears. Materials and Methods The present study was a prospective experimental study which was carried out in 50 samples of women attending at Acharya Harihar Regional Cancer Centre, a span of 1 year. The Student’s unpaired ‘t’ test was used to analyse the data. Result There was a progressive rise in the AgNOR counts with the severity of the lesions [normal cytology \ inflammatory \ low squamous intraepithelial lesion \ high squamous intraepithelial lesion \ malignant of cervix, i.e. 1.68 \ 2.50 \ 4.09 \ 5.94 \ 8.60, respectively]. Each lesion had a significant AgNOR value which helped in differentiating it from its precursor lesion. Conclusion The AgNOR counts have been immensely helpful as they behave as a cell proliferative marker, aiding the diagnosis which is made through the cervical PAP-stained smears and letting the cytopathologist understand the exact stage of the cervical lesion. Keywords AgNOR PAP stain LSIL HSIL
Introduction Cervical cancer is one of the most dreaded forms of genital cancers in females after breast cancer [1]. Over 80% of the cervical cancers present at a fairly advanced stage, and around 80,000 deaths have been reported to be caused by cervical cancer in India per year [2]. The human papillomavirus (HPV) infection has been at the forefront in the development of cancer of the cervix all over the globe. Besides HPV as an obvious infective risk factor, the associated factors which propagate cervical malignancies include age, multiparty, sexual partners, an early age of
& Gangotree Mohanty [email protected] Ashok Kumar Padhy [email protected] 1
Ravenshaw University, Cuttack, Odissa 753003, India
2
Department of Gynaecology and Obstetrics, Acharya Harihar Regional Cancer Centre, Cuttack, Odissa 753003, India
marriage, oral contraceptives, tobacco, family history and immunosuppression [3]. The field of cytopathology, off late, has seen advancements, with various types of special staining techniques, one such technique is silver staining of the nucleolar organizer regions of the nucleus—once stained, these regions behave as cell proliferation markers, the indications of the cell ploidy and the proliferation status. AgNORs are chromosomal loops of DNA involved in ribosomal synthesis, which are stained with silver methods as black dots in the nuclei. Their size and number reflect the nucleolar and cell proliferative activity of tumours. AgNOR number and distribution in the nucleus are useful in tumour detection and prognosis.
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