Prognostic Significance of Two Dimensional AgNOR Evaluation in Local Advanced Rectal Cancer Treated with Chemoradiotherapy

  • Gundog, Mete (Departmentof Radiation Oncology, Kayseri Education and Research Hospital, University of Erciyes) ;
  • Yildiz, Oguz G (Departmentof Radiation Oncology, Kayseri Education and Research Hospital, University of Erciyes) ;
  • Imamoglu, Nalan (Department of Basic Pharmaceutical Sciences, Kayseri Education and Research Hospital, University of Erciyes) ;
  • Aslan, Dicle (Departmentof Radiation Oncology, Kayseri Education and Research Hospital, University of Erciyes) ;
  • Aytekin, Aynur (Department of Radiation Oncology, Kayseri Education and Research Hospital, University of Erciyes) ;
  • Soyuer, Isin (Department of Pathology, Kayseri Education and Research Hospital, University of Erciyes) ;
  • Soyuer, Serdar (Departmentof Radiation Oncology, Kayseri Education and Research Hospital, University of Erciyes)
  • Published : 2016.01.11


The prognostic significance of AgNOR proteins in stage II-III rectal cancers treated with chemoradiotherapy was evaluated. Silver staining was applied to the $3{\mu}m$ sections of parafin blocked tissues from 30 rectal cancer patients who received 5-FU based chemoradiotherapy from May 2003 to June 2006. The microscopic displays of the cells were transferred into the computer via a video camera. AgNOR area (nucleolus organizer region area) and nucleus area values were determined as a nucleolus organizer regions area/total nucleus area (NORa/TNa). The mean NORa/TNa value was found to be $9.02{\pm}3.68$. The overall survival and disease free survival in the high NORa/TNa (>9.02) patients were 52.2 months and 39.4 months respectively, as compared to 100.7 months and 98.4 months in the low NORa/TNa (<9.02) cases. (p<0.001 and p<0.001 respectively). In addition, the prognosis in the high NORa/TNa patients was worse than low NORa/TNa patients (p<0.05). In terms of overall survival and disease-free survival, a statistically significant negative correlation was found with the value of NORa/TNa in the correlations tests. Cox regression analyses demostrated that overall survival and disease-free survival were associated with lymph node status (negative or positive) and the NORa/TNa value. We suggest that two-dimensional AgNOR evaluation may be a safe and usable parameter for prognosis and an indicator of cell proliferation instead of AgNOR dots.


Two-dimensional AgNOR;chemoradiotherapy;morphometry;rectal cancer


Supported by : EURF (Erciyes University Research Fund)


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