NUCLEOLAR ORGANIZER REGIONS IN ADENOCARCINOMA OF THE UTERINE CERVIX

Background. Nucleolar organizer regions (AgNORs) are associated with p roliferative activity and ploidy in many tumors. The endocervical grow th pattern of cervical adenocarcinoma renders tumor volume assessment more difficult, necessitating additional prognostic indicators. Method s. Thirty-five cases of cervical adenocarcinoma were evaluated by revi ewing charts and histologic sections. Nucleolar organizer regions were stained and counted manually; the mean number per cell and the percen tage of cells with more than 5 AgNORs were recorded. Ploidy and S-phas e fraction were determined by flow cytometry. Results. Mean AgNOR coun ts per cell were significantly higher in adenocarcinoma (3.0) and aden osquamous carcinoma (4.3) than in benign endocervical epithelium (1.4) . Grade 3 tumors had higher values (4.0) than Grade 1 lesions (2.9), a nd tumors with lymphovascular space involvement had higher values (3.5 ) than tumors without such involvement (2.7). No significant correlati on was seen with regard to tumor stage or size. Flow cytometric parame ters did not correlate with any of the examined parameters, although t he DNA index was higher in larger tumors. Correlation between AgNOR co unts and flow cytometry was significant only in Grade I tumors. Conclu sions. Nucleolar organizer region counts correlated better with histol ogic parameters of cervical adenocarcinoma than did flow cytometry. Be cause it is easily performed and does not require sophisticated equipm ent, AgNOR counts should be investigated further in a larger group of patients to determine their prognostic value.