Number of argyrophilic nucleolar organizer regions is a good indicator of lymph node metastasis in patients with esophageal carcinoma

Abstract

The number of argyrophilic nucleolar organizer regions (AgNORs) was evaluated as a predictor of lymph node metastasis in 45 patients who had undergone resection of advanced squamous cell carcinoma of the esophagus. The mean AgNOR score of carcinomas was 5.0 +/- 1.8, and it was greater than that of normal esophageal epithelium adjacent to a carcinoma (2.3 +/- 0.5, P < 0.001). The AgNOR score of tumors from 26 patients with lymph node metastasis was 6.1 +/- 1.6, and it was greater than that of tumors from 19 patients without lymph node metastasis (3.7 +/- 1.0, P < 0.001). The AgNOR scores of metastatic lymph nodes (4.9 +/- 1.5) from 26 patients with lymph node metastasis were closely related to the number of metastatic lymph nodes of individual patients (r = 0.582, P < 0.0001). The 3-year survival rate in patients with low AgNOR scores (AgNOR score < 5, n = 22) was 56.2%. By contrast, that in patients with high AgNOR scores (AgNOR score > or = 5, n = 20) was only 13.1%. There was a statistically significant difference between the two survival curves (P < 0.05). These results indicate that the AgNOR score is a good indicator of lymph node metastasis and suggest that it might also be a useful prognostic marker in patients with esophageal cancer.

Correlation between the Lymphocytic Infiltration of Tumors and the Proliferative Activity of Cancer Cells from Surgically Treated Esophageal Carcinoma

“…The biological characteristics associated with the high malig nant potential of esophageal squamous cell carcinoma are being studied by many researchers. In the current study, we recognized that the proliferative activity of cancer cells was a good indicator of the malignant potential of esopha geal carcinoma, as reflected by lymph node metastasis or poor prognosis [7,12,13]. The murine monoclonal anti body Ki-67 was raised against a crude nuclear fraction of a cell line from a patient with Hodgkin's disease [14], It binds to a nuclear antigen that is expressed at all stages of the cell cycle except GO, and immunostaining with Ki-67 can be used to detect the proliferative activity of cells [4][5][6]15], Moreover, it has been reported that LI, which is an example of the local immune reaction of the host, is close ly correlated with a better prognosis in several cancers, such as renal cell carcinoma, breast cancer, and colon can cer [1,2],…”

“…The prognosis of patients with gastric or colorectal cancer with extensive lymphocytic infiltration seems to be significantly better than that of patients who have tumors without lymphocytic infiltration [1.2], However, the rela tionship between the local immune reaction of the host and the biological characteristics of tumor cells remains to be defined. It has widely been recognized that the proliferative activity of cancer cells is a useful parameter in trying to understand tumor behavior [3], and the proliferative activity of cancer cells has been shown to be closely relat ed to malignant potentials, for example, to lymph node metastasis, or to poor prognosis in gastric, colorectal, breast, and esophageal cancer [4][5][6][7], In this study, to evaluate the correlation between the behavior of cancer cells, the host's immune response against the tumor, and the prognosis of patients with esophageal cancer, we compared the proliferative activity of cancer cells by immunostaining with the Ki-67 anti body (Ki-67 score), which is directed against a nuclear antigen associated with cell proliferation, and the extent of LI in the same specimen. Moreover, we compared the prognosis of patients with esophageal cancer in the same stage according to the Ki-67 score and the extent of LI of the tumor.…”