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Photomicrograph (a) showing Small AgNORs (100X; AgNOR stain), (b) showing Large AgNORs (100X; AgNOR stain).
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Aims:
Silver stainable nucleolar organizer regions (AgNORs) have received a great deal of attention recently as their frequency within the nuclei is significantly higher in malignant cells than in normal, reactive or benign neoplastic cells. The objective of this study was to carry out a quantitative assessment of large and small AgNORs in oral no...
Contexts in source publication
Context 1
... were strictly located within the cell nucleus and were distinctly stained in black as dots and blebs that were either round or elongated: the rest of the nucleus stained yellow-brown. The mean number of small NORs (Fig. 1a), large NORs (Fig. 1b) and total AgNORs, calculated for normal, dysplastic and squamous cell carcinoma cases is shown in Table ...
Context 2
... were strictly located within the cell nucleus and were distinctly stained in black as dots and blebs that were either round or elongated: the rest of the nucleus stained yellow-brown. The mean number of small NORs (Fig. 1a), large NORs (Fig. 1b) and total AgNORs, calculated for normal, dysplastic and squamous cell carcinoma cases is shown in Table ...
Context 3
... observed throughout, there was an increase in num- ber of small AgNORs in squamous cell carcinomas (mean 3.25) compared to that of dysplastic lesions (mean 2.05) and normal mucosa (mean 1.17) (Table 1, Fig. 2). The large AgNORs were increased in dysplastic lesions (1.71) and squamous cell carcinomas (1.94) as compared to nor- mal mucosa (0.78) but the difference is not as remarkable as seen with the small AgNORs. ...
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Citations
... The mean value of the same in OL cases in our study was seen to be 5.68±0.40, which could be related to the study done by Chowdhry et al. [27] who observed a mean value of the same in epithelial dysplasia to be 5.61±4.63 and in candidal dysplasia to be 5.67±4.83. In our study, the number of profiles of AgNOR per nucleus (n NOR) of OSCC showed a value of 7.92±0.70. ...
... In our study, the number of profiles of AgNOR per nucleus (n NOR) of OSCC showed a value of 7.92±0.70. These results could be compared to other studies done by Cabrini et al. [19], Chowdhry et al. [27], and Schwint et al. [20]. ...
Background
Silver stainable nucleolar organizer regions (AgNORs) have proven to exhibit utmost importance due to their higher occurrence in the nucleus especially in malignant cells than in normal. Thus, they assist in the examination of nucleolar structures and variations in nucleolar activity.
Aim
Quantitative and qualitative analysis in relation to the number and area of AgNOR in tissue sections of the normal oral mucosa (NOM), oral leukoplakia (OL), and oral squamous cell carcinoma (OSCC) was the main aim of the study.
Materials & method
A total of 50 cases comprising 20 OL with dysplasia, 20 OSCC cases, and 10 samples of normal oral mucosa were taken. Silver nitrate (Sol A) & gelatin (Sol B) solutions were freshly prepared for staining the lesional slides.
Results
The mean value of nuclear profile area (A Nuc) was comparatively higher in oral leukoplakia i.e. 41.97 and in oral squamous cell carcinoma i.e. 62.36 in comparison to the control group where it was 36.19. The mean value of a single AgNOR profile area per nucleus (A NOR) was found to be comparatively lower in both study groups i.e. oral leukoplakia (2.76) and oral squamous cell carcinoma (1.61) in comparison to the control group (3.45) . The mean value of total AgNOR profile area per nucleus (TA NOR) and the number of profiles of AgNORs per nucleus (n NOR) were found higher in both study groups (oral leukoplakia and oral squamous cell carcinoma) as compared to normal oral mucosa of the control group.
However, the findings of all four parameters of morphometric analysis were found to be significantly associated with disorder of oral mucosa i.e. cases of oral leukoplakia and oral squamous cell carcinoma (P value <0.01).
Conclusion
It can thus be suggested that the mean AgNOR count displayed a higher value in OSCC. Hence, the number of AgNORs in nuclei increases as epithelial cells undergo malignant transformation which is designated that mean AgNOR count may contribute to establishing the prognosis of a lesion.
... Every year considerably high number of new invasive cancer cases are diagnosed. Out of these cancers, oral cancer has a very high incidence 55 . Although the microbiome differs in the healthy oral cavity and oral squamous cell carcinoma (OSCC), the pathogenic bacteria or bacterial spectrum associated with OSCC is yet to be identified 28 . ...
The oral cavity is home to diverse microbial content, collectively called as the oral microbiome. The latest technological advancements have unraveled the intricacies of the oral microbiome. It can be of great importance for oral health care givers to know the fundamentals and latest developments in the field of the oral microbiome, as oral dysbiosis is associated with many common diseases frequently seen and managed by them. These diseases include dental caries, periodontitis, mucosal diseases (such as oral leukoplakia, oral lichen planus, and systemic lupus erythematosus), oral cancers, and even co-infections related to the current COVID-19 pandemic.
The emergence of new genomic and molecular biology methodologies has been pivotal for understanding the role of the human microbiome in health and disease. The current review compiles oral microbiome in health and disease with a multidisciplinary dental approach. The insight into the oral microbiome, which is provided dental specialty wise in the current article will initiate and guide researchers of various disciplines in developing microbiome-based therapeutic or prophylactic management strategies, public health challenges by microbiome-based boarder interventions and divert resources for preserving and achieving a balanced oral microbiome.
... [sup] [28] Chattopadhyay et al. investigated the AgNOR counts in the epithelia of oral mucosa, oral leukoplakia and oral SCC, and found that AgNOR counts in SCC were found to be significantly more than others. A statistically significant difference was found between normal epithelium and leukoplakia, between normal epithelium and SCC as well as between leukoplakia and SCC. ...
Context: Head and neck squamous cell carcinoma (HNSCC) consists of squamous cell carcinomas (SCCs) arising in the upper aerodigestive tract and accounts for 5% of cancers worldwide. In Malaysia, cancers of the nasopharynx, larynx, tongue and oral cavity are among the top twenty most common cancers in men. Argyrophilic nuclear organizer regions (AgNORs) are increased from normal mucosa to premalignant lesions to malignant lesions and have been associated with tumor grade and prognosis of patients. Although p73 is not mutated in human cancers, high levels of p73 expression have been associated with tumor differentiation status and patient prognosis. Aims: To investigate the correlation between AgNORs and p73 immunoexpression. Settings and Design: Fifty-two formalin-fixed, paraffin-embedded HNSCC cases and ten controls were collected from the Hospital. Subjects and Methods: Tissue blocks were sectioned, dewaxed and rehydrated before silver nitrate staining to determine the AgNOR count and immunohistochemical staining to determine the p73 expression. Adopting the scoring system used by Chen et al. for p73 staining, the proportion of positively stained cells in the whole epithelial layer was determined. Staining was considered positive if >10% of epithelial cells were stained. Statistical Analysis Used: Spearman's correlation coefficient was calculated using SPSS 18 software to determine the relationship between the p73 score against tumor differentiation, mean AgNOR counts and tumor grade and between the mean AgNOR count and p73 score. Results: Positive results were found in the immunoexpression of p73. Positive results were seen with the staining of AgNOR; however, in comparison with the entire sample size, a significant correlation between mean AgNOR count and p73 immunohistochemical expression was not obtained. Conclusions: AgNOR count showed a linear and decreasing trend as the p73 score increases. This correlation was statistically insignificant.
... They also play a very important role in the estimation of the cellular activity that is applied to a variety of neoplastic as well as hyperplastic lesions. 26 Variations in the size and/or number of the AgNOR dots may depend on the stage of the cell cycle, the transcriptional and metabolic activity of the cell, or the number of NOR bearing chromosomes in the karyotypes. The AgNOR count is used as a marker of cellular proliferation. 2 Xie X et al. stated in 1997 that the number of AgNOR at any given stage in the cell cycle appears to be inversely proportional to the cell cycle time, i.e., the higher the amount of AgNOR, the shorter the cell cycle time. ...
Early detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) is important for dental professionals to improve patient survival rates. More than half of patients with oral squamous cell cancer had advanced disease at the time of diagnosis, indicating a lack of early detection and risk assessment biomarkers. The development of new protein biomarkers will help in early diagnosis and treatment.The argyrophilic nucleolar organiser regions (AgNORs) staining technique is simple and cost-effective. These are replicatory markers that identify epithelial dysplasia. And it also plays a very important role in differentiating the benign, pre-malignant, and malignant lesions of the oral cavity. The number of AgNORs per cell has been considered an indicator of cellular proliferative activity. Microscopically, NORs can be identified as well-defined black dots located throughout the cell nucleus. The agNOR quantity is strictly proportional to the proliferative activity of the cell. AgNOR quantification helps in the determination of the degree of epithelial dysplasia and, consequently, in the analysis of its potential for malignant transformation. AgNOR qualitative characteristics help in differentiating hyperplastic, premalignant, and malignant oral lesions. The sliver staining technique is useful for studying the structure of the nucleolus as well as the variations in its activity. AgNORs are a valuable parameter in tumour pathology.
... 12 While Chowdhary A. et al (2013) found significantly different mean value of normal mucosa (1.95) to oral squamous cell carcinoma (5.19). 13 The reason for the greater number of AgNORs in the nuclei of malignant lesions is undetermined it may represent an escalation in ploidy, increased gene amplification or a rise in chromosomal segregation with more cells being in the Sphase of their cycle. 13 In the present study, the mean value of smaller AgNOR size in the control group was 1.03. ...
... 13 The reason for the greater number of AgNORs in the nuclei of malignant lesions is undetermined it may represent an escalation in ploidy, increased gene amplification or a rise in chromosomal segregation with more cells being in the Sphase of their cycle. 13 In the present study, the mean value of smaller AgNOR size in the control group was 1.03. In this group, type I distribution pattern (60%) and type II pattern of distribution (40%) were observed. ...
Background: Argyrophilic nucleolar organizer regions (AgNORs) has been considered to be useful indiagnostic pathology, mainly to distinguish benign lesions from their malignant counterparts.Aim: This study was done to evaluate the significance of various AgNOR parameters in differentiatingpremalignant and malignant oral lesions.Materials and Methods: The study was performed on thirty five archival tissues consisting of samplecomprised of five normal mucosa, fifteen premalignant lesions and fifteen malignant oral lesions. AgNORswere assessed both quantitatively and qualitatively. The data were analyzed using ANOVA and Chi squaretest.Results: Quantitatively and qualitatively significant difference was noticed. Quantitatively significantdifference in the mean value of AgNORs noticed between the premalignant and malignant lesions. In termsof qualitatively, the premalignant and malignant oral lesions differed significantly from normal mucosa.Conclusion: To conclude, the AgNOR count is the most appropriate marker to differentiate betweenpremalignant and malignant oral lesions.
... 19 Furthermore, studies suggest that with the malignancy of the lesion, the number of AgNORs tends to increase. 27 Thus, it is hypothesized that the number of NORs of oral leukoplakias would be directly proportional to the increase in their histopathological grading. ...
Aim:
This study relates the average number of nucleolar organizing regions (NORs) obtained in a series of cases of oral leukoplakia, with three methods of histopathological classification of such lesion.
Materials and methods:
This is a histopathological-histochemical laboratory cross-sectional study. The 18 cases of leukoplakia analyzed were filed at Pathology Service of the Biological Sciences Institute of the University of Passo Fundo, Rio Grande do Sul, Brazil (SDH/ICB/UPF) (2017 and 2018), from which epidemiological data were extracted. New histological sections were performed for impregnation by the argyrophilic nucleolar organizer regions (AgNOR) technique. The histopathological slides were analyzed by photon microscopy (1,000×), and the nuclei of 100 epithelial cells were photographed to count the number of NORs. Three methods were used for the lesions' histopathological classification [World Health Organization (WHO), Brothwell, and binary system]. The means of NORs were compared with the three histopathological classifications by means of the t or analysis of variance (ANOVA) statistical tests, at a significance level of 5%.
Results:
According to the WHO classification method, most cases (11-61.1%) had a moderate classification. Evaluations by the Brothwell method showed moderate and mild classification in 50 and 38.9% of cases, respectively. According to the binary system, most cases (10-55.6%) had low risk. The average NORs found in 100 nuclei of each of the 18 lesions ranged from 2 to 4. When crossing the average NORs with the histopathological classification methods of the lesions by means of the t test or ANOVA, no significant relationship was noted.
Conclusion:
The average of NORs is not associated with the histological classifications of leukoplakias. Thus, the AgNOR method should be used with caution when differentiating different histological grades of leukoplakias.
Clinical significance:
The AgNOR method should be used with caution to determine the clinical treatment of oral leukoplakias, since no agreement was observed between this method and the histopathological classifications available for such lesion.
... When mean values of total AgNORs were tallied between dysplastic lesions and SCCs, a highly significant increase was found in SCCs. [28] Chattopadhyay et al. investigated the AgNOR counts in the epithelia of oral mucosa, oral leukoplakia and oral SCC, and found that AgNOR counts in SCC were found to be significantly more than others. A statistically significant difference was found between normal epithelium and leukoplakia, between normal epithelium and SCC as well as between leukoplakia and SCC. ...
Context: Head and neck squamous cell carcinoma (HNSCC) consists of squamous cell carcinomas (SCCs) arising in the upper aerodigestive tract and accounts for 5% of cancers worldwide. In Malaysia, cancers of the nasopharynx, larynx, tongue and oral cavity are among the top twenty most common cancers in men. Argyrophilic nuclear organizer regions (AgNORs) are increased from normal mucosa to premalignant lesions to malignant lesions and have been associated with tumor grade and prognosis of patients. Although p73 is not mutated in human cancers, high levels of p73 expression have been associated with tumor differentiation status and patient prognosis.
Aims: To investigate the correlation between AgNORs and p73 immunoexpression.
Settings and Design: Fifty-two formalin-fixed, paraffin-embedded HNSCC cases and ten controls were collected from the Hospital.
Subjects and Methods: Tissue blocks were sectioned, dewaxed and rehydrated before silver nitrate staining to determine the AgNOR count and immunohistochemical staining to determine the p73 expression. Adopting the scoring system used by Chen et al. for p73 staining, the proportion of positively stained cells in the whole epithelial layer was determined. Staining was considered positive if >10% of epithelial cells were stained.
Statistical Analysis Used: Spearman?s correlation coefficient was calculated using SPSS 18 software to determine the relationship between the p73 score against tumor differentiation, mean AgNOR counts and tumor grade and between the mean AgNOR count and p73 score.
Results: Positive results were found in the immunoexpression of p73. Positive results were seen with the staining of AgNOR; however, in comparison with the entire sample size, a significant correlation between mean AgNOR count and p73 immunohistochemical expression was not obtained.
Conclusions: AgNOR count showed a linear and decreasing trend as the p73 score increases. This correlation was statistically insignificant.
... [13] NORs are useful in the determination of cellular activity and application in neoplastic lesions. [14] Proliferation rates may be assessed by AgNORs on cytologic or histologic preparations. [15] Anticipating survival in human neoplasia is aided by the use of AgNOR number, pattern, and distribution. ...
Aim and Objective: The role of prognosis cannot be stressed enough, especially when it comes to potentially malignant lesions. The argyrophilic nucleolar organizer regions (AgNORs), which is simple and cost-effective has been used in diagnostic and prognostic pathologies. This study seeks to identify the nucleolar organizer regions (NORs) in oral submucous fibrosis (OSMF), to correlate the AgNOR count with the histologic grade of OSMF, and to evaluate the prognostic potential of AgNOR. Materials and Methods: The sample size consisted of archival paraffin blocks of 35 cases of varying grades of OSMF and 10 cases of squamous cell carcinoma. Normal mucosa samples served as controls for the study. AgNOR staining in accordance with the method of Smith and Crocker was performed and Student's t-test was used for statistical analysis. Results: The results showed an increase in AgNOR counts with corresponding grades of OSMF, the count being least in normal mucosa and also an increase in AgNOR count with corresponding decrease in differentiation of oral squamous cell carcinoma. Conclusion: AgNOR staining is a rapid and inexpensive procedure representing cellular proliferation that can be used to assess the nature of the lesion and therefore, the prognosis.
... [13] NORs are useful in the determination of cellular activity and application in neoplastic lesions. [14] Proliferation rates may be assessed by AgNORs on cytologic or histologic preparations. [15] Anticipating survival in human neoplasia is aided by the use of AgNOR number, pattern, and distribution. ...
Aim and objective:
The role of prognosis cannot be stressed enough, especially when it comes to potentially malignant lesions. The argyrophilic nucleolar organizer regions (AgNORs), which is simple and cost-effective has been used in diagnostic and prognostic pathologies. This study seeks to identify the nucleolar organizer regions (NORs) in oral submucous fibrosis (OSMF), to correlate the AgNOR count with the histologic grade of OSMF, and to evaluate the prognostic potential of AgNOR.
Materials and methods:
The sample size consisted of archival paraffin blocks of 35 cases of varying grades of OSMF and 10 cases of squamous cell carcinoma. Normal mucosa samples served as controls for the study. AgNOR staining in accordance with the method of Smith and Crocker was performed and Student's t-test was used for statistical analysis.
Results:
The results showed an increase in AgNOR counts with corresponding grades of OSMF, the count being least in normal mucosa and also an increase in AgNOR count with corresponding decrease in differentiation of oral squamous cell carcinoma.
Conclusion:
AgNOR staining is a rapid and inexpensive procedure representing cellular proliferation that can be used to assess the nature of the lesion and therefore, the prognosis.
... Some authors have shown that the number of NORs/ nucleus increases from the ED to OSCC [15,16,18,20,24,25]. Considering the WHO classification of dysplasia, an increasing of indexes of AgNORs from lesions with lower degrees of dysplasia to lesions with more severe dysplasia [26] has been demonstrated. ...
... On the other hand, Spolidorio et al. [19] found no difference in the AgNORs count between the ED and OSCC; however, a distinction was found in the AgNORs morphology based on their size, shape, and distribution pattern within the nucleus. Although various mean AgNOR related parameters (count, area, perimeter, and proportion) can be used to compare normal oral epithelium from dysplastic and nondysplastic leukoplakia [24], according to Garg et al. [27], the AgNOR count is the most appropriate marker to differentiate between dysplastic and nondysplastic leukoplakia. ...
Histologically, these lesions can range from hyperkeratosis and acanthosis to epithelial dysplasia and even OSCC. The aim of this study was to investigate the proliferative activity, using AgNORs quantification proteins, in low- and high-risk oral epithelial dysplasia, OSCC, and nondysplastic epithelium (inflammatory fibrous hyperplasia). The sample was divided into 4 groups: G1: 10 cases of inflammatory fibrous hyperplasia (IFH), G2: 11 cases of low-risk epithelial dysplasia (LD), G3: 10 cases of high-risk
epithelial dysplasia (HD), and G4: 11 cases of OSCC.The quantitative analysis was performed using an image processing software in photomicrographs at 1000x magnification. The one-way ANOVA was used for comparison of the mean AgNORs counts between the study groups. The mean AgNORs count was significantly higher (𝑃 ≤ 0.01) in OSCC when compared to IFH and the LD; however, it was not statistically different from HD. The mean number of LD was significantly lower than the HD and OSCC, with
no difference related to IFH. AgNORs quantification can be an important and cheap method to help in the determination of the degree of epithelial dysplasia and, consequently, in the analysis of their potential for malignant transformation.
