Evaluation of Diagnostic Value of AgNOR Technique in Differentation Between Non-Neoplastic(Benign) and Malignant Lesions in Urine Cytology

This cross-sectional study was carried out to evaluate the usefulness of AgNOR technique in differentiation between benign and malignant cells in urine cytology and to determine the expression of Argyrophilic Nucleolar Organizer Region(AgNOR) proteins as a marker of proliferative activity in benign and malignant urothelial cells. Quantification of AgNORs which was stained by the silver colloid method in urothelial cells was carried out on voided urine from 75 cases composed of 43 Non-Urothelial Neoplastic(NUN) cases and 32 Transitional Cell Carcinoma(TCC) with varied degree of tumoral grade (grade I: 6 cases, Grade II: 16 cases, Grade III: 6 cases, Grade IV: 4 cases) which had been proved by gold standard method of bladder biopsy. The Mean AgNOR Count(MAC) showed stepwise increase in NUN cases(mean=3.19) through Grade I of TCC(mean=3.86), Grade II of TCC(mean=4.20), Grade III of TCC(mean=7.44) and Grade IV of TCC(mean=8.34). Oneway ANOVA Test and Post Hoc(Scheffe method) were used to compare the results between the groups. The mean differences were significant between low grade TCC(Grade I, II) and high grade TCC(Grade III, IV), and also between NUN group and high grade TCC(Grade III, IV). On the other hand, there were no significant statistical differences between the NUN group and Grade I TCC and also between Grade III and Grade IV. The mean maximum number of AgNOR in each group showed the same results.