در افتراق بين لنفوم هوجكين ، غير هوجكين و هيپرپلازي راكتيو AGNOR ارزش تشخيصي رنگ آميزي

Diagnostic value of AgNOR staining in the differentiation between Hodgkinʹs non-Hodgkinʹs lymphoma and benign lymphoid lesion

AgNOR staining as a cell proliferating marker has been used in the diagnosis, differentiation, and prognosis of different malignant and benign neoplasms. This study was performed in order to evaluate the application of AgNOR staining technique in differentiation of malignant from benign lymphoid lesions and also in classification of different types of lymphoma. In this technique the numbers and the mean of maximum diameter of dots in cell nuclei are measured on optical microscopy level. In this study, 100 cases of benign and malignant lymphoid lesions were collected and paraffin sections of 3ʹ"" thickness were prepared (fixed in 10%formalin). The quality and quantity values of nucleolar organizer regions (NORs) were evaluated by means of AgNOR staining method. The numbers of AgNOR dots on 100 cells in each slide were counted randomly by optical microscopy method by oil immersion lens with xl000 magnification. Maximum diameter (Dmax) of AgNOR dots was measured by morphometric interactive image analysis system (Carl-zeiss) on photographic pictures taking by digital camera microscope on final magnification of x4000. AgNOR staining was performed by modified Crocker technique. The number of mean AgNOR count, the percent of cells witch have more than 3 dots, equal or more than 5 dots and Dmax, of AgNORs were evaluated for correlation and significance of difference between values using statistical software of SPSS. It was observed that the mean counts of AgNOR dots and the percent of cells with more than 3 and equal or more than 5 dots were significantly increased in reactive nodes, Hodgkin disease and malignant lymphomas respectively.There were increasing values for the mean counts of AgNOR dots and the percent of cells with more than 3 and equal or more than 5 dots, from low grade to intermediate and finally high-grade Non Hodgkinʹs lymphomas. The order was reverse for Dmax, of AgNORs in above cases (greater values in reactive nodes and less values in high grade Non Hodgkinʹs lymphomas). Also the changes in parameter of Dmax values were according to prognostic classification of Hodgkin disease. In all cases the differences between values were highly significant (p<0.001) and strong correlation was observed between parameters. It seems, AgNOR staining is a valuable and simple method for differentiation of neoplastic and reactive lymphoid lesions, classification of Non-Hodgkinʹs lymphomas and prognosis.