AgNORs Count and DNA Ploidy in Liver Biopsies from Patients with Schistosomal Liver Cirrhosis and Hepatocellular Carcinoma.

Objectives: Argyrophilic nucleolar organizer regions (AgNOR) proteins are a set of argyrophilic nucleolar proteins that accumulate in highly proliferating cells, whereas their expression is very low in nonproliferating cells. The present study aimed to investigate the potential of DNA flow cytometry (FCM) and AgNORs count in the assessment of cellular kinetics of liver cirrhosis and hepatocellular carcinoma.

Design and methods: Small-needle liver biopsies (217) were included and were taken from 84 patients with hepatocellular carcinoma (HCC) (one biopsy from tumor lesion and the other from residual non tumor) liver tissues. Only one biopsy was taken from 49 patients with liver cirrhosis. One part of biopsy was subjected to flow cytometry, and the other, to histopathology and AgNORs counting.

Results: An aneuploidy was shown in 44.5% of liver cirrhosis and in 78.6% of tumor sites. Aneuploid HCC cases showed high AgNORs count compared with diploid cases (3.407±1.18 vs. 1.74±0.9). An extremely significant increase in AgNORs count in tumor lesion (Pb0.001) was found compared with residual liver tissues, liver cirrhosis and normal liver (3.89±0.827, 1.49±0.52, 1.62±0.29, and 1.3±0.17, respectively). In liver cirrhosis, dysplasia showed a significant relationship with ploidy (Pb0.001) and AgNORs count (Pb0.05).

Conclusion: AgNORs count and DNA ploidy analysis of core biopsy specimens are useful in the assessment of cellular kinetics of liver cirrhosis and hepatocellular carcinoma.

Keywords: Argyrophilic nucleolar organizer regions; Liver cirrhosis; Hepatocellular carcinoma; Ploidy; Flow cytometry.