Objective: When planning treatment of ovarian cancer, the prognostic factors should be considered. One of them is the amount of nucleolar organizer regions (AgNORs) in cancer cells, which reflects proliferative activity of the tumor.
Design: To estimate the influence of chemotherapy on the AgNORs count in serous ovarian cancer cells.
Material and methods: 26 women who underwent surgical procedure and then chemotherapy between 1998-2002 due to serous ovarian cancer were included into the study. During the initial surgery the cancer stage I was detected in 1 case, stage II in 2 cases, stage III in 12 cases, and stage IV in 11 cases. In all cases during second-look laparotomy, which was performed after 6 courses of chemotherapy (paclitaxel, cisplatinum), the persistent disease was found. In 17 out of 26 cases it was disseminated neoplasmatic disease. In all cases the specimens were prepared according to one-step AgNORs method described by Howell and Ploton. In cancer cells the mean number of AgNORs per nucleus (mAgNOR) and the mean percentage of nuclei with five or more AgNORs per nucleus (pAgNOR) were counted.
Results: The mAgNOR and pAgNOR mean number before chemotherapy were respectively: 4, 22 +/- 0.94 and 35.62 +/- 19.90. After treatment the mAgNOR and pAgNOR were significantly lower, and the data were respectively: 3.67 +/- 0.91 and 24.15 +/- 19.53. In 4 cases (15.4%) the mAgNOR increased, in 7 cases (26.9%) the change was not significant, and in 15 cases (57.7%) the mAgNOR decreased. In 6 cases (23.1%) the pAgNOR increased, in 5 cases (19.2%) the change was not significant, and in 15 cases (57.7%) the pAgNOR decreased. We did not found any correlation between the tendency to change the number of AgNORs and staging, the amount of persistent neoplasmatic tissue, the range of primary surgery, as well as grading.
Conclusions: The number of AgNORs per nucleus in most cases of ovarian cancer after chemotherapy was lower. The tendency to change the number of AgNORs was not connected with staging as well as grading.