Role of Argyrophilic Nucleolar Organizer Region (AgNOR) Study in Cytological Evaluation of Serous Fluids for Detection of Malignancy

BACKGROUND Malignant tumours cause effusion by direct involvement of serous membranes by tumour invasion, or by secondary inflammatory reaction causing serous effusions. Identification of tumour cells in serous fluids is often difficult by regular cytology. Nucleolar Organizer Regions (NORs) are loops of DNA situated in acrocentric chromosomes. These NORs are evaluated by silver staining technique that recognizes these argyrophilic proteins which are bigger and are more dispersed in malignancies. A total of 97 serous effusions received at the Department of Pathology, GMC, Bhopal were included in the study. Smears were studied by conventional Papanicolaou and haematoxylin and eosin stains. Variation of AgNOR dots in smears were graded and compared in malignant and non-malignant effusions. AgNOR dispersion up to 1 + was observed in maximum patients with reactive mesothelial cells whereas AgNOR dispersion of 3 + was observed in 80 % patients with malignant cells. Similarly, AgNOR size was up to 1 + in maximum cases with reactive mesothelial cells whereas it was 3 + in 70 % cases with malignant cells. The present study observed statistically significant association of AgNOR dispersion and size with malignant as well as reactive mesothelial cells (p < 0.01). The study of AgNOR size and dispersion was found to be clinically useful as an ancillary diagnostic tool for use in serous effusion when the cytologic diagnosis is ambiguous.

[1]  Maria Rose Palathingal.  Role of Argyrophilic Nucleolar Organiser Region Staining in Effusions for Detection of Malignancy - Diagnostic Test Evaluation , 2017 .

[2]  Muaz O Fagere.  Diagnostic Utility of AgNORs Staining of Serous Effusion among Sudanese Patients , 2016 .

[3]  S. Karki,et al.  The role of argyrophilic nucleolar organizer region (AgNoR) study in cytological evalution of fluids, especially for detection of malignancy. , 2012, Kathmandu University medical journal.

[4]  Veena Gupta,et al.  Role of argyrophilic nucleolar organizer region staining in identification of malignant cells in effusion , 2011, Journal of cytology.

[5]  M. Jordá,et al.  Effusion Cytology: A Practical Guide to Cancer Diagnosis , 2011 .

[6]  S. Khan,et al.  AgNOR Proliferative Index in Malignant Pleural and Peritoneal Effusions , 2005 .

[7]  Gulshan Akhtar,et al.  AgNOR STAINING IN MALIGNANT AND BENIGN EFFUSIONS , 2004 .

[8]  S. Torabinezhad,et al.  DIFFERENTIATION BETWEEN BENIGN, REACTIVE ANDMALIGNANT CELLS IN SEROSAL BODY FLUIDS BY AGNOR STAINING , 2002 .

[9]  Luis Alberto Palaoro,et al.  Utilidad de la técnica de AgNOR en la interpretación de los derrames de cavidades serosas , 2000 .

[10]  M. Derenzini.  The AgNORs. , 2000, Micron.

[11]  W. Wilmanns,et al.  Identification of carcinoma cells in ascitic and pleural fluid. Comparison of four panepithelial antigens with carcinoembryonic antigen. , 1992, Acta cytologica.

[12]  P. Hozák,et al.  Quantitative ultrastructural study of nucleolus‐organizing regions at some stages of the cell cycle (G0 period, G2 period, mitosis) , 1988, Biology of the cell.

[13]  M. Derenzini,et al.  DISTRIBUTION OF INTERPHASE NUCLEOLAR ORGANISER REGIONS AND DIAGNOSIS OF MALIGNANCY , 1987, The Lancet.

[14]  J. Crocker,et al.  Nucleolar organiser region associated proteins in cutaneous melanotic lesions: a quantitative study. , 1987, Journal of clinical pathology.

[15]  R. Mcwilliam,et al.  BLEEDING AND PERIOPERATIVE HEPARIN , 1974 .

[16]  W. Murphy,et al.  Determination of primary site by examination of cancer cells in body fluids. , 1972, American journal of clinical pathology.

[17]  Emmerich Vonllaam.  THE CYTOLOGY OF EFFUSIONS , 1970 .

[18]  M. Ferguson-Smith,et al.  Observations on the satellited human chromosomes. , 1961, Lancet.