Relationship of AgNOR counts and nuclear DNA content to survival in patients with parathyroid carcinoma

Abstract

The aim of this study was to evaluate the usefulness of DNA flow cytometry to determine tumor nuclear DNA index (DI), and nucleolar organizer region protein counts visualized by the argyrophil (AgNOR) technique, in confirming diagnosis and predicting clinical outcome of patients with parathyroid carcinoma (PC). We reviewed paraffin-embedded tissue sections, from 15 patients (median age 63 years, range 30-68 years) with PC who died of the disease, which were randomly compared with tissue sections from 15 age-and sex-matched patients with parathyroid adenoma (PA). The proliferative activity in parathyroid tumours as detected by DI and AgNOR counts was evaluated in all specimens. Both DI (1.37 AE 0.33 vs 1.0 AE 0.1) and AgNOR (3.01 AE 0.31 vs 1.54 AE 0.35) counts were higher ðP < 0:001Þ (Student's t-test) in patients with PC than in those with PA. Diploid (DI¼1), aneuploid (DI > 1) and hypoploid (DI < 1) neoplasms were found in 11 (PC ¼ 4, PA ¼ 7), 14 (PC ¼ 11, PA ¼ 3) and five (PC ¼ 0, PA ¼ 5) patients respectively. The average postoperative survival in patients with PC was 46.9 AE 37.4 months (range 21-146 months). The survivals of patients with aneuploid ðn ¼ 11Þ and diploid ðn ¼ 4Þ PC were 74.0 AE 58.1 and 34.1 AE 18.4 months (P=0.21) respectively. There was a significant relationship between DI and AgNOR counts (R=0.69, P < 0:01), but no correlation was found between survival and both DI (Rho ¼ 0.17, P ¼ 0:55) and AgNOR counts (Rho ¼ 0.26, P ¼ 0:35). Moreover, there was no correlation ðP ¼ NS) between the main preoperative biochemical parameters and survival. In conclusion, DI and AgNOR are useful in confirming the diagnosis of PC, but they are of little value in predicting the clinical outcome of patients with PC.

Evaluation of preoperative ultrasonographic and biochemical features of patients with aggressive parathyroid disease: is there a reliable predictive marker?

“…Although parathyroid carcinoma (PC) is an uncommon finding, accounting for only 1-2% of patients with primary hyperparathyroidism (PHPT); a relatively higher incidence has been reported in Italy and Japan, in consistent with our study (28,29). Another possible etiology that can explain the higher incidence may be the fact that our hospital is a tertiary center receiving more complicated cases who are candidates for surgery.…”

Methods in Neuroendocrine Histopathology, A Methodological Overview

“…The stain has been widely applied in a variety of cell kinetic studies, using the mean number of argyrophil "(Ag) NORs" of the tumour cells mainly as a marker for cell proliferation. The staining method, initially developed by Goodpasture & Bloom (42), modified by Howell & Hsu (45) and Li et al (46), has provided additional information to predict malignancy in some endocrine tumours (47)(48)(49).…”

Silver-Stained Nucleolar Organizer Regions in Normal and Dysplastic Cervical Lesions: Correlation with DNA Ploidy and S-Phase Fraction by Flow Cytometry

“…The results of the present study also showed that samples with high AgNOR were showing aneuploid DI and high SPF. Thus, DI and AgNOR are both useful in confirming the diagnosis [37] and high AgNOR count holds promise for the prediction of disease aggressiveness [33, 35, 38]. …”