SILVER-STAINED NUCLEOLAR ORGANIZER REGIONS ASSOCIATED PROTEIN (AGNOR)ANALYSIS - A MAJOR PROGNOSTIC FACTOR IN GASTRIC-CARCINOMA

Background: Argyrophilic nucleolar organizer regions associated protei ns (AgNORs) are known to reflect cellular transcriptional activity. Th eir standardized visualization at light microscopical level with subse quent morphometric analysis have been shown to provide a simple, inexp ensive and reliable routine parameter to determine proliferative activ ity, which is considered to be of significance regarding prognosis in cancer patients. Patients and Method: Quantitation of AgNORs was carri ed out by standardized staining and morphometric analysis on a series of 110 surgical resected gastric carcinomas. The AgNOR content per nuc lei is expressed by standardized AgNOR parameters (coefficient of vari ation (CV) of number and area of AgNORs per nucleus). Results: Standar dized AgNOR parameters were shown to be statistically significantly (C V of AgNOR number: p<0.001; CV of AgNOR area: p<0.01) correlated with the clinical course of patients after surgical resection of gastric ca rcinoma. A multivariate analysis of all clinico-pathological features showed that R stage (p = 0.0001), UICC stage (p = 0.0001), and AgNOR q uantity (p = 0.01) were statistically significantly and independently associated with survival. Conclusions: Standardized analysis of AgNORs is proposed as an important independent prognostic factor in surgical resected gastric carcinoma. The method is suitable for routine use on paraffin embedded archival material.