PROGNOSTIC VALUE OF QUANTITATIVELY MEASURED AGNORS IN DUCTAL MAMMARY-CARCINOMA

Argyrophilic proteins of nucleolar organizer regions (AgNOR proteins) were stained by a modified silver staining technique. Paraffin section s from 137 cases of invasive ductal carcinoma of the breast were inves tigated. The nuclei and AgNOR dots were quantitatively measured by mea ns of a semiautomatic image analysis system. Follow-up data for about 120 months (mean, 102+/-47) and clinical/histologic and DNA distributi on parameters were available for all patients. The prognostic signific ance of AgNOR parameters was tested by Cox regression analysis. Four A gNOR features showed a significant univariate correlation with surviva l time. In multivariate analysis offering all the available parameters , one AgNOR parameter (coefficient of variation of relative AgNOR area ) ranked at the third position beyond the standard deviation of DNA di stribution and pTNM/staging. When considering the distant recurrence-f ree survival of patients, the same AgNOR feature provided significant additional prognostic information. Performing survival analysis for th e prognostically defined subgroup of pTNM/stage I patients and offerin g all DNA and AgNOR features the same AgNOR parameter yielded the high est prognostic validity. These results show that quantitatively measur ed AgNORs yield prognostic factors in breast cancer.