A study on the nucleolar organizer regions-as a tumour proliferative marker in cervical smears

J Clin Diagn Res. 2013 Feb;7(2):278-83. doi: 10.7860/JCDR/2013/4808.2746. Epub 2012 Nov 22.

Abstract

Aim: To study the Argyrophilic Nucleolar Organizer Regions (AgNOR) as a cell proliferative marker in cervical smears and to assess its counts with the severity of the lesions on Papanicolaou (PAP) stained cervical smears.

Material and method: The present study was a prospective experimental study which was carried out at Jawaharlal Nehru Medical College in a span of 2 years. 50 high risk cases were selected from the Gynaecological OPD. The cervical smears were collected in pairs, one for the conventional PAP staining and the other one for the specialized AgNOR staining.

Statistical analysis: The Student's unpaired 't' test was used.

Observation: There was a progressive rise in the AgNOR counts with the severity of the lesions [normal cervix< chronic cervicitis< low squamous intraepithelial lesion (LSIL)< High Squamouus Intraepithelial Lesion (HSIL) carcinoma cervix i.e. 1.75 < 2.09 < 2.81 < 4.17< 5.98 respectively]. Each lesion had a significant AgNOR value which helped in differentiating it from its precursor lesion.

Conclusion: The AgNOR counts have been immensely helpful as they behave as a cell proliferative marker, aiding the diagnosis which is made through the cervical PAP stained smears and letting the cytopathologist understand the exact stage of the cervical lesion.

Keywords: AgNOR; Carcinoma of the cervix; Cervical lesions; PAP.