PROGNOSTIC-SIGNIFICANCE OF STANDARDIZED AGNOR ANALYSIS IN EARLY AND ADVANCED GASTRIC CARCINOMAS

To assess the prognostic significance of silver-stained nucleolar orga nizer region (AgNOR) proteins, a standardized AgNOR analysis was perfo rmed on 78 patients affected by early (EGC, n=24) or advanced (AGC, n= 54) gastric carcinomas. The histopathological diagnosis, grading and s taging were done according to WHO and UICC recommendations; the mean f ollow-up time was 56.9 months. Visualization and quantification of Ag NORs were made in formalin-fixed, paraffin-embedded sections as specif ied in the guidelines of the Committee on AgNOR Quantification (1995). Statistical analysis was performed on the mean AgNOR area values (NOR A). Highly significant differences (P<0.001) were found in NORA values between EGC and AGC, between low- and high-grade gastric carcinomas a nd between patients dead from gastric cancer and living patients. In a ddition, significant P values were found on comparison of NORA values relating to pT status, pN status and stage. Comparison of Kaplan-Meier survival curves revealed that patients affected by gastric carcinomas with higher NORA values (>5.213 mu m(2)) had a worse prognosis. Final ly, using Cox multiple regression analysis, the AgNOR quantity emerged as a useful independent prognostic variable to predict the final outc ome of patients affected by EGC or AGC.