Silver Stained Nucleolar Organizer Regions Count in OSC Carcinoma

OBJECTIVES: to find out whether AgNOR count correlate with clinical pathological features of prognostic importance in OSCC and to see whether AgNOR count can provide additional prognostic information on biological behavior of OSCC. METHODS: The study included 111 patients with OSCC who attended at Muhimbili National Hospital, Tanzania. RESULTS: The tumor size ranged from 2-12 cm in greatest dimension with mean diameter of 5.74±(1.84SD). 60.4% of patients had 1-3 palpable lymph nodes, and only one patient had metastasis to the lungs during the initial diagnosis. Majority of patients (82.0%) had stage IV tumors, whereas only 6.3% had stage III, and 11.7% had stage II tumors. No patient was encountered with stage I tumor. Histologically, 77.5% were well-differentiated tumors (G1), 14.4% were moderately well differentiated (G2) and 8.1% were poorly differentiated tumors (G3). Mean AgNOR count of tumors without palpable lymph nodes (N0) had significantly lower count (4.87) than those with palpable lymph nodes with 7.58, 7.02 and 11.60, for N1, N2 and N3, respectively. Poorly differentiated tumors (G3) had statistically higher mean AgNOR count (8.43) than G2 (6.15) and G1 (5.64) tumors (p>0.04). However, the highest mean AgNOR count was encountered in a number of G1 tumors. Mean AgNOR count also correlated well with tumor stage. Stage II had the lowest mean count of 4.23, whereas stage III and IV had mean counts of 5.80 and 6.45, respectively (p=0.03). CONCLUSION: AgNOR count correlated well with conventional prognostic indicators of OSCC. AgNOR showed potential ability of identifying some aggressive tumors that histologically and/or according to other prognostic parameters appear to have less aggressive. AgNOR method can be used as an additional marker to predict the biological behavior of OSCC and therefore it may be performed prior to treatment of an individual patient.