[Assessment of the AgNORs count in serous ovarian cancer]

Abstract

Objective: The survival rate of patients with ovarian cancer strongly depends on staging and grading. The next potential, independent prognostic factor might be the amount of nucleolar organizer regions (AgNORs) in cancer cells.

Design: To assess the relationship between AgNORs count in serous ovarian cancer and grading, the size of primary tumor, the evaluation of peritoneal fluid and clinical staging.

Material and methods: 69 women who underwent surgical procedure due to serous ovarian cancer between 1998-2002 were included into the study. In each case the clinical and histopathological assessment of neoplastic disease was made. In all cases the specimens were prepared according to the 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 in cancer cells varied from 3.22 to 7.19 (mean 4.31+/-0.81), and the pAgNOR varied from 5% to 84% (mean 39.74+/-20.58%). According to the grading of cancers it was as follows: 3.74+/-0.25 and 22.12+/-10.03 in G1 tumors, 4.13+/-0.56 and 35.52+/-13.94 in G2 tumors, and 4.75+/-0.92 and 52.26+/-20.65 in G3 tumors. All the differences were statistically significant. We did not find any correlation between the size of primary tumor and mAgNOR as well as pAgNOR. There were no correlations between the presence as well as the amount of ascitic fluid, and mAgNOR as well as pAgNOR. The positive correlation between the presence of cancer cells in peritoneal fluid and pAgNOR, but not mAgNOR was found. The values of mAgNOR and pAgNOR in clinical stages were respectively: 3.94+/-0.44 and 27.11+/-15.71 for stage I, 4.14+/-0.62 and 39.25+/-22.53 for stage II, 4.27+/-0.79 and 38.76+/-19.79 for stage III, 4.55+/-0.92 and 46.42+/-20.71 for FIGO stage IV. The positive correlations between staging and mAgNOR as well as pAgNOR were found.

Conclusions: The number of AgNORs per cell is one of the sensitive methods in the assessment of ovarian cancer agressiveness and positively correlates with grading and staging of the disease.