The Evaluation of Argyrophilic Nucleolar Organizing Region Proteins in Fine-Needle Aspiration Samples of Thyroid
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The Evaluation of Argyrophilic Nucleolar Organizing Region Proteins in Fine-Needle Aspiration Samples of Thyroid Recep Eroz & Nurhan Cucer & Zuleyha Karaca & Kursad Unluhizarci & Figen Ozturk
Published online: 10 May 2011 # Springer Science+Business Media, LLC 2011
Abstract Argyrophilic nucleolar organizing region associated proteins (AgNORs) have been shown to be of interest in a variety of different diseases including thyroid disorders. Our aim was to distinguish benign thyroid lesions from papillary thyroid carcinoma (PTC) via AgNOR count and with a new approach, via AgNOR surface area/total nuclear surface area (NORa/TNa) proportions in the nuclei on fine-needle aspiration (FNA) materials. Thirty patients (eight men and 22 women) whose FNA was compatible with benign lesion and 26 patients (eight men and 18 women) whose FNA was compatible with PTC were included in the study. Fine-needle aspiration materials were stained for AgNOR detection according to a specific protocol. One hundred nuclei per individual have been evaluated, and AgNOR
number and NORa/TNa proportions of individual cells were measured and calculated by using a computer program. Patients with PTC had significantly (p2.93, Fig. 2 AgNOR number/nucleus (AUC=0.988) AUC area under the ROC curve
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Fig. 1 Microscopic images of evaluated cells: a normal thyrocyte, b benign lesion, and c thyrocyte from papiller thyroid carcinoma
Discussion The AgNOR technique provides an index of cell proliferation. The number, shape, and distribution of AgNOR dots counted in the cell gives information not only about the morphology but also about the behavior of the cell. The correlation between AgNOR numbers and cell proliferation has been widely investigated in tumors by comparing AgNOR values with kinetic data obtained by applying a panel of proliferation markers. Therefore, the AgNOR parameter can reflect the neoplastic nature of cells and represents a promising prognostic indicator in tumor pathology [14–16]. In the current study, AgNOR method was applied to FNA smears of thyroid in order to find an aid in distinguishing papillary carcinomas from benign lesions of the thyroid. AgNOR technique has been applied in tumor pathology for both diagnostic and prognostic purposes. However, the lack of a standardized silver-staining protocol has led to much misinterpretation of actual structures evaluated in individual studies. For this reason, absolute AgNOR scores reported by different authors for the same types of tumors are difficult to compare and the results produced by these investigations sometimes seem to be conflicting [17]. Camargo et al. investigated the discriminating potential of AgNOR area measurement and count in thyroid tumors. The authors found that AgNOR evaluation was not a significant parameter to discriminate between malignant Fig. 2 a Sensitivity and specificity value for AgNOR number/nucleus. b ROC derived cutoff values for AgNOR number/nucleus
and benign thyroid lesions. However in that study, the authors investiga
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