ABSTRACT
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 nontumor) 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 (P<0.001) 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 (P<0.001) and AgNORs count (P<0.05). 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.
Subject(s)
Aneuploidy , Antigens, Nuclear , Carcinoma, Hepatocellular/pathology , DNA/genetics , Liver Cirrhosis/pathology , Liver Neoplasms/pathology , Liver/pathology , Schistosomiasis/pathology , Biopsy, Needle , Carcinoma, Hepatocellular/genetics , Flow Cytometry , Humans , Liver Cirrhosis/etiology , Liver Cirrhosis/genetics , Liver Neoplasms/genetics , Schistosomiasis/complications , Schistosomiasis/geneticsABSTRACT
There is controversy among pathologists when assessing the presence or absence of liver cell dysplasia in liver biopsies taken from cirrhotic patients. The objective of the present study was to determine the DNA ploidy pattern of hepatocytes of patients with liver cirrhosis and its relationship to liver cell dysplasia. A total of 48 male patients diagnosed with liver cirrhosis based on clinical, laboratory and histopathological criteria were included in the study. A liver biopsy was taken from each patient; one part of the biopsy was subjected to histopathology, and the other to flow cytometry. The histopathological examination revealed liver cell dysplasia in 60% of patients with liver cirrhosis (62% of them had large cell dysplasia [LCD] and 38% had small cell dysplasia [SCD]). Abnormal DNA content (aneuploidy) was found in 81.5% of positive liver cell dysplasia specimens and found only in 11.1% of negative liver cell dysplasia specimens, with a statistically significant difference (P<0.001). Aneuploidy was found more commonly in LCD but without significant difference (P>0.05) in comparison with SCD. In conclusion, SCD (similar to LCD) is also associated with aneuploidy and elevated DNA index, and may carry the same risk for progression to hepatocellular carcinoma.
