Nucleolar organiser regions in adenocarcinoma in situ of the endocervix.

Abstract

SUMMARY The AgNOR technique was used to analyse 11 cases of adenocarcinoma in situ of the endocervix and five examples of healthy cervices to assess whether areas of "increased nuclear activity" could be located adjacent to the malignant tissue. Areas of adenocarcinoma in situ had significantly more AgNOR staining dots than apparently normal bordering areas ("transitional areas") and areas of endocervical epithelium remote from adenocarcinoma in situ. There were no significant differences between AgNOR counts in transitional areas and areas remote from adenocarcinoma in situ, and between these areas and histologically normal cervices.These observations provide no support for the hypothesis that areas of glandular atypia of lesser severity or zones of "increased nuclear activity" exist adjacent to adenocarcinoma in situ.Adenocarcinoma in situ is believed to be a precursor of invasive cervical adenocarcinoma. It is an uncommon lesion, although its true incidence has probably been underestimated.' Various authors have found that glandular atypia of the cervix was strongly associated with cervical squamous intraepithelial neoplasia (CIN),2 and one group observed glandular atypia of lesser severity than adenocarcinoma in situ in crypts adjacent to areas of CIN3 in 15% of cases.3 Although we have not observed such a high incidence of cervical glandular atypia in association with CIN3, we might have overlooked most glandular atypias. Given the observation by the same workers that adenocarcinoma in situ was found separated from normal crypts by intervening areas of lesser grades of atypia, we investigated whether there are areas adjacent to adenocarcinoma in situ which show differences in the numbers of nucleolar organiser regions (NORs), as measured by the silver impregnation (AgNOR) method. For if it could be shown that there was a measurable change in nuclear "activity", this might support the concept of the existence of a transitional zone of pre-neoplastic mucosa which is not easily recognisable on routine histological staining. We also felt that it would be useful to determine whether the preferred sites for neoplastic transformation-that is, the crypts adjacent to the squamocolumnarjunctiondiffered from the rest of the endocervix by using the same technique in healthy cervices.Accepted for publication 27 July 1989 Material and methods Cases ofclassic adenocarcinoma in situ were identified by one of us (TPR) from the pathology files of the Birmingham and Midland Hospital for Women.Sections 3 gm thick were cut from routinely processed paraffin wax blocks. These were dewaxed in xylene and hydrated through ethanols to double distilled deionised water. A staining solution was prepared which consisted of gelatin dissolved in 10 g/l aqueous formic acid at a concentration of 20 g/l, mixed with 500 g/l aqueous silver nitrate (1 volume gelatin/formic acid to 2 volumes silver nitrate). This mixture was poured over tissue sections which were left in a humidity chamber in the dark for one hour at room temperature. The silv...

How Useful is the AgNOR Staining Method for the Diagnosis of Salivary Gland Tumors?

“…The mean of AgNOR dots in epidermoid cells also increased as the tumor grade increased, which confirms the higher tendency for malignancy. A similar increase in the AgNOR dot numbers has also been reported in other high-grade tumors (19,20). These findings also seem to be in agreement with the overall indolent biological behavior of MEC.…”

Endocervical Glandular Atypia: Does a Preneoplastic Lesion of Adenocarcinoma In Situ Exist?

“…There was no support for the hypothesis that areas of glandular atypia of lesser severity exist adjacent to AIS. 5 We believe that our study and a critical scrutiny of the literature supports the idea that benign endocervical cell changes and EGA are not part of a spectrum of partially transformed preneoplastic cells that culminates in AIS. Although the concept of a glandular mucosal neoplastic transformation identical to what some have proposed occurs within the cervical squamous mucosa is attractive, we believe there is no morphologic evidence to support it.…”

Argyrophilic nucleolar organizer regions in benign hyperplastic and cancerous human prostates

“…An individual dot is counted as one, whether separately or in cluster, or cluster and satellite dot are equally counted as one. These two ways of counting seem equally useful in separating benign and malignant lesions in melanoma and uterine cervical tumor [20,21]. The present study used the former method; it may be stressed that the former method is more useful to distinguish benign and malignant cells, since tumor cells with a low Gleason pattern had a tendency to make clusters with a few satellite dots, and these cells might be counted by the latter method as smaller values similar to those in benign cells (see Fig.…”