Diagnostic importance of AgNOR pleomorphism in cervical carcinogenesis

OBJECTIVE Nucleolar organizer region (NOR) associated proteins are argyrophilic and visualized by silver stains. AgNOR pleomorphic dots increase in cancer and most researchers have done a common count of single dots. Pleomorphic dots are few and perhaps indicate a more severe prognosis. The present study was aimed at investigating the relative preponderance and diagnostic value of both pleomorphic and single AgNOR dots in cervical carcinogenesis. STUDY DESIGN Silver nitrate staining was performed in 50 cervical smears each of cytologically diagnosed normal, inflammatory, low grade squamous intraepithelial lesion (LSIL), High-grade squamous intraepithelial lesion (HSIL), and squamous cell carcinoma cases registered at C.S.M. Medical University, Lucknow, India. RESULTS The accumulated data revealed a positive and significant correlation of cell counts of both pleomorphic (r = 0.94; p < 0.01) and single dots (r = 0.95; p < 0.01) with disease severity. The rate of increase in cell counts of pleomorphic dots (β = 2.61) was 1.1 times higher than the rate of increase in cell counts of single dots (β = 2.29). CONCLUSION This study indicates the diagnostic potential of pleomorphic dots in the process of cervical carcinogenesis. The number of pleomorphic dots also varies significantly in different types of SIL, which may help in discriminating precancerous lesions of the cervix.