Silver-Stained Structures in Prostatic Carcinoma: Evaluation of Diagnostic and Prognostic Relevance by Automated Image Analysis

Abstract

The comparison of the diagnostic and prognostic significance of histology, immunohistochemical parameters (PSA, PSP), and silver-stained nucleolar organizer regions (AgNORs) was estimated in paraffin sections taken of 63 prostatic carcinomas prior to therapy. AgNORs were visualized with a one-step silver staining technique with the appropiate staining time determined by preliminary staining-time series. The mean AgNOR number per cell (n) and the mean AgNOR area per silver-stained dot (A) were determined by means of an automatic image analysis system. Thereby prostatic carcinomas exhibited multiple small AgNORs within their nuclei (n = 4.7, A = 0.09 µm2), whereas benign prostatic epithelium showed few but large silver-stained particles (n = 1.8, A = 0.27 µm2; p < 0.001). This relationship was then calculated as a quotient of AgNOR number and area (NQ = n/A) which provided additional information for the diagnosis of malignancy as well as survival. Univariate survival analysis disclosed a set of four variables predicting death from prostatic cancer: cribriform growth pattern, AgNOR quotient, histological grade, and PSA immunoreactivity. Of these parameters, immunoreactivity of PSA failed to prove its prognostic significance in multivariate survival analysis (Cox model). No relation to prognosis was found for the number as well as the area of AgNORs alone. Therefore, image analysis proved to be a prerequisit for the feasibility of this promising technique by providing objective and reproducible results.

Argyrophilic Nucleolar Organizer Regions in Atypical Adenomatous Hyperplasias, Prostatic Intraepithelial Neoplasias and Prostatic Neoplasms

“…However, the dif ference between poorly differentiated adenocarcinoma and M D A C was statistically not significant. Similar find ings have been reported earlier where the N O R counts increased up to grade 6 of Gleason's histological grade but not in tumours of grade 7 or more [13,14,20], The changes in the distribution of N ORs (number and size) reflect a different arrangement of actively transcribing D N A without notable changes in the total volume [21], Therefore, after a certain extent, the increase in NOR number is limited.…”

“…In the present study, the normal prostatic tissue and BPH sections had a mean N O R count of 2.87 ± 0.39 and 3.84 ± 0.40 NORs/nucleus, respectively, being slightly higher than the previously observed mean N O R count of 1.58 and 1.81 in normal prostatic tissue [12,13] and in BPH (1.72 NORs/nucleus) [14]. However, our finding compared favourably with the observations of some of the other workers where mean N O R counts in BPH were found to be 4.51 and 3.39, respectively [7,15], The mean N O R count in BPH with chronic prostatitis was 4.9 ± 0.55 which was significantly more (p < 0.05) than that seen in normal prostate and BPH without pros tatitis.…”

Argyrophilic nucleolar organizer regions of thyroid lesions on fi ne needle aspiration smears

“…6 The role of AgNOR is already well established in the diagnosis of oral cavity tumors, breast lesions, lymphoma and prostatic tumors. [7][8][9] However correlative studies of AgNOR staining with the cytomorphological features in FNAC of thyroid lesions are very few and inconsistent. 3 Hence in the present study, utility of AgNOR staining in FNAC smears of thyroid lesions is analyzed in the context of its use in differentiating benign and malignant lesions.…”

New Prognostic Factors in Prostatic Carcinoma

“…Transforming growth factor a is another polypeptide growth factor of 5.6 kD with a single chain of 50 amino acids [115] [ 143] found no ERBB2 expression in any of the prostatic carcinomas, whereas Ware et al [144] reported ERBB2 immunoreactivity in about 88% of prostatic carcinomas and in all hyperplasias. Also a recent study from 34 freshly frozen benign prostatic hyperplasias and 29 prostatic carcino mas showed that 18% of hyperplasias and 21 % of carcino mas were ERBB2 positive [ 134].…”