Argyrophilic nucleolar organizer region (AgNOR) technique: a helpful tool for differential diagnosis in urinary cytology

• Published in: Cytopathology (Oxford) 1999-02, Vol.10 (1), p.30-39
• Main Authors: CIA, E. M. M., TREVISAN, M., METZE, K.
• Format: Article
• Language: English
• Subjects: AgNOR; analyse discriminante; cancer; Cytodiagnosis - methods; cytologie; cytology; Diagnosis, Differential; diagnostic différentiel; differential diagnosis; Differentialdiagnostik; Discriminant Analysis; Diskriminanzanalyse; Humans; Nucleolus Organizer Region - pathology; Predictive Value of Tests; Urinzytologie; Urologic Diseases - pathology; Urologic Neoplasms - pathology; urothelium; urothélium
• ISSN: 0956-5507; 1365-2303
• DOI: 10.1046/j.1365-2303.1999.00145.x

Argyrophilic nucleolar organizer region (AgNOR) technique: a helpful tool for differential diagnosis in urinary cytology The aim of this study was to investigate whether the AgNOR technique could be helpful for the cytologic diagnosis of neoplastic and non‐neoplastic urinary tract lesions. We analysed the AgNOR pattern in urinary cytology in samples from 70 patients. In every case the average number of silver precipitations per nucleus was counted and the range between the minimum and maximum AgNOR value calculated. Furthermore we noted whether the AgNOR precipitations had a homogeneous or heterogeneous distribution. The diseases were classified in three groups: non‐neoplastic lesions, low grade and high grade carcinoma. Linear discriminant analysis (with jack‐knife procedure) was performed with the AgNOR parameters as independent variables. The final diagnosis of each patient had been established by histological analysis of bladder biopsies. We obtained a correct classification in 84.3% of the cases. All patients with normal or reactive lesions were correctly classified and only two cases of low grade malignancy were erroneously diagnosed as non‐malignant. Five high grade neoplasms had been classified as low grade and four low grade carcinomas had been over‐diagnosed as high grade neoplasms. We conclude that a combined qualitative and quantitative AgNOR analysis can be useful in the differential diagnosis of urinary cytology. La technique des AgNOR: un outil utile pour le diagnostic différentiel en cytologie urinaire L'objectif de cette étude a été de démontrer l'utilité de la technique des AgNOR pour le diagnostic des lésions urinaires tumorales et non‐tumorales. Nous avons analysé la distribution nucléaire des AgNOR dans la cytologie urinaire de 70 patients. Pour chacun des cas, le nombre de grains d'argent a été compté et l'écart entre les valeurs minimales et maximales a été calculé. De plus, le caractère homogène ou hétérogène de la distribution des grains d'AgNOR a été noté. Les pathologies ont été classées en 3 groupes: lésions non‐tumorales, carcinomes de faible et de haut grade. Ces paramètres AgNOR ont fait l'objet d'une analyse discriminante non paramétrique (avec la procédure ≪Jack‐Knive≫ ou du ≪canif≫). Le diagnostic final a étéétabli pour chaque patient par l'examen histologique des biopsies vésicales. Nous avons obtenu une classification correcte dans 84,3% des cas. Tous les patients du groupe non‐tumoral ont été bien classés et deux cas se