PROGNOSTIC-SIGNIFICANCE OF NUCLEOLAR ORGANIZER REGIONS IN HEPATOCELLULAR-CARCINOMA

It has been suggested that the number of argyrophilic nucleolar organi zer regions (AgNORs) correlates with cellular activity and the aggress iveness of malignancy. The mean number of AgNORs per nucleus may, ther efore, be a prognostic factor for hepatocellular carcinoma (HCC). The purpose of this study was to evaluate the prognostic significance of t he number of AgNORs in HCC. The silver-staining technique was applied to surgically resected specimens to indicate AgNORs. Eighty-nine of th e specimens were of HCC, 23 were of normal liver adjacent to HCC, and 32 were of cirrhotic liver adjacent to HCC. The number of AgNORs of HC C (mean +/- SD, 3.26 +/- 1.23) was significantly higher than those of normal liver (1.37 +/- 0.13) and cirrhotic liver (1.49 +/- 0.14). The number of AgNORs was significantly correlated with serum alpha-fetopro tein level, tumor size, portal vein invasion, and Edmondson-Steiner hi stological grade. In patients undergoing curative resection, the survi val rate of those with a high number (>3.04) of AgNORs was significant ly worse than that of those with a low number (less than or equal to 3 .04) of AgNORs. Multivariate analysis showed that the number of AgNORs was a significant variable when all patients undergoing curative rese ction were assessed together. The results of this study suggest that t he number of AGNORs is useful as an indicator of the grade of malignan cy and as a predictor of the prognosis of patients with HCC who do not have portal vein involvement.