Evaluation of AgNORs in gallbladder lesions

Background: Quantification of argyrophillic nucleolar organizer regions (AgNORs) is a good indicator of cellular proliferation activity and is useful diagnostic tool to estimate the malignant potential of lesions in gallbladder. The aim of the present study was to study the AgNORs and assess their correlation with various lesions of the gallbladder. Methods: This study was conducted in the department of pathology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India. One hundred specimens of gall bladder lesions (50 cases chronic cholecystitis,30 cases epithelial hyperplasia and 20 cases of carcinoma) were study subjects. AgNOR staining was done on three micron thin sections of paraffin embedded tissue, as per the method of Crocker and Smith with safranin counterstain. The number of AgNORs, stained as black dots was counted in one hundred adjacent cells in different lesions. Results: Mean AgNOR count in chronic cholecystitis, epithelial hyperplasia and carcinoma was 2.44±0.31, 3.88±0.39 and 7.90±0.76 respectively. AgNOR counts in various lesions gradually increased from chronic cholecystitis to carcinoma and the increase was statistically significant (p<0.05). Conclusions: Despite inter-laboratory variations and lack of standardization of counts for a particular lesion, AgNOR technique is easy to perform, economical and reliable indicator of malignant potential of the gall bladder lesions, hence can be used in resource poor set up as an adjunct to histopathology.