THE DIAGNOSTIC-VALUE OF SILVER NUCLEOLAR ORGANIZER REGION ASSESSMENT IN BREAST CYTOLOGY

Benign and malignant breast lesions in cytologic preparations can be d ifficult to distinguish. The authors applied the silver nucleolar orga nizer region (AgNOR) technique to cytologic preparations obtained from surgical specimens to evaluate its diagnostic usefulness in making th is distinction. Sixty-two benign and 36 malignant lesions were examine d. AgNORs were counted and evaluated using a subjective scoring techni que to examine AgNOR size, shape, and clustering. The benign lesions h ad a mean count of 4.44 AgNORs/nucleus (95% CI, 2.4-6.5) and the malig nant cases, 9.52 AgNORs/nucleus (95% confidence interval, 7.4-11.7; P< .0005). The median score for benign cases was 7 and for malignant case s, 13 (P<.0001). With a few exceptions, cases with high counts bad hig h scores. The diagnostic accuracy of combined counting and pattern ass essment was 90%. The likelihood ratio for correct diagnosis using AgNO R counting was 14:1 and for AgNOR scoring, 13:1.