Standardized AgNOR analysis of the invasive tumour front in oral squamous cell carcinomas

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Abstract
In the last decade, silver staining of nucleolar organizer region‐associated proteins (AgNORs) has been widely used in tumour pathology both for diagnostic and for prognostic purposes. However, a reliable and reproducible assessment of these proteins on routinely processed archival tissues has only become possible since the recent introduction of standardized staining method and computer‐aided morphometric analysis. In the present study, the AgNOR content at the invasive front of 80 squamous cell carcinomas of the floor of the mouth/tongue was investigated using this novel approach, with regard to prognosis and a variety of clinico‐pathological parameters. All standardized AgNOR parameters [mean of AgNOR number, mean of AgNOR area, coefficients of variation (CV) of both AgNOR number and area] were statistically significantly associated with the clinical course. The strongest correlation was found for the AgNOR‐area univariate analysis (P=0·006). In multivariate analysis, the mean of AgNOR number could independently predict both overall (P=0·01) and disease‐free survival (P=0·001). It is concluded that standardized staining and computer‐aided analysis of AgNORs are prerequisites for an objective and reproducible AgNOR assessment, which has potential as a supplementary diagnostic and prognostic tool in oral cancer. © 1997 John Wiley & Sons, Ltd.

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