Variations in the activity of nucleolar organizers in different tissues, demonstrated by silver staining of human normal and leukemic cells

Nucleolar organizer regions (AgNOR) and subepithelial vascularization as field cancerization markers in oral mucosa biopsies of alcoholic and smoking patients

OBJECTIVE

The aim of this study was to show that variations in nucleolar organizer regions (AgNOR) and the increase in subepithelial vascularization could reveal changes related to markers of field cancerization in alcoholic and smoking patients who have not yet expressed clinical or histological malignant lesions.

STUDY DESIGN

Quantitative variations in epithelial AgNOR and in the vascularization of the underlying connective tissue were assessed by image analysis in histologically normal biopsy specimens from alcohol drinkers and smoking patients (DS). AgNORs were evidenced by silver staining and vessel walls were labeled by immunohistochemical demonstration of the CD34 antigen. Samples of oral mucosa of nonalcoholic, nonsmoking patients (NDS) obtained during surgical procedures served as controls. Eight parameters related to number, volume, and shape of nuclei and AgNORs, and 4 parameters related to number and diameter of vascular sections were evaluated. Differences between DS and NDS groups were statistically evaluated by means of ANOVA test and posterior Bonferroni comparisons.

RESULTS

The morphometric analysis revealed more irregular-shaped AgNORs in the superficial and suprabasal layers of the oral mucosa of DS patients. The suprabasal layers also exhibited a significantly larger number of AgNORs. The normal oral mucosa of DS patients exhibited a greater vascular density, with predominance of small-caliber blood vessels underlying the basement membrane.

CONCLUSION

The variations in AgNOR and epithelial vascularization would be practical biomarkers to evaluate changes underlying the augmented risk of cancerization in oral mucosa.

Ag-NOR staining and satellite association in lymphoproliferative disorders

The nucleolar organizer regions (NORs) activity and the frequency of satellite associations (SA) in peripheral blood lymphocytes from patients with two chronic lymphoproliferative disorders were studied: 10 cases with B-cell chronic lymphocytic leukemia (B-CLL) and 10 with mycosis fungoides (MF). Thirteen healthy individuals formed the MF control group, and the oldest 7 constituted the B-CLL control group. The mean of Ag-NORs per metaphase was increased in B-CLL patients (8.80 +/- 0.63) compared with their controls (7.99 +/- 0.90) (P less than 0.025), meanwhile MF patients' value did not differ from their controls. In both disorders, the frequency of Ag-NORs in the G chromosomes was increased. The analysis of SA in B-CLL patients only revealed an increase in the frequency of cells with more than 4 ASPs (association pairs). Meanwhile, a significant higher mean of ASPs per cell in MF patients (1.74 +/- 0.41) compared to controls (1.40 +/- 0.24) (P less than 0.05) was observed. Furthermore, a close correlation between cells with complexes of 3 or more chromosomes and the mean of ASPs per cell was also found in MF. In conclusion, an increase of the Ag-NORs expression in B-CLL patients and a modification in the degree of SA in MF patients were found.

Ag-NOR staining and satellite association in bone marrow cells from patients with mycosis fungoides

Silver staining of nucleolus organizing regions (Ag-NORs) of acrocentric chromosomes and the frequency of satellite association (SA) in bone marrow (BM) cells from 7 patients with mycosis fungoides (MF), were studied. BM samples of 7 normal healthy individuals were taken as controls. The mean number of Ag-NORs per metaphase was increased in patients (7.20 +/- 0.25) compared with controls (5.40 +/- 0.16) (p < 0.002), related with the increase of the D group. Moreover, a significant higher percentage of Ag-NOR positive cells in patients (71.7 +/- 3.9) than controls (48.0 +/- 7.8) (p < 0.02), was seen. The analysis of SA revealed a significant increase in the percentage of cells with 1-2 association pairs (ASPs) in patients with respect to their controls (p < 0.05), and a trend to a decrease in the percentage of cells without ASPs. Furthermore, a correlation between the number of Ag-NORs and the mean of ASPs per cell was also found for patients (rk = 0.65; p < 0.05). These results may be associated with a certain degree of immaturity, a high proliferative activity and modifications of the growth rate of BM cells in MF patients.

Age related decrease of NOR activity in bone marrow metaphase chromosomes from healthy individuals

AIMS

To present data obtained from human bone marrow preparations from healthy individual showing that the proportion of metaphases with silver stained nucleolar organiser region (AgNOR) chromosomes is associated with the age of the donor.

METHODS

Bone marrow preparations from eight Russian and 10 Argentinian healthy individuals donating bone marrow for heterologous transplantation were studied by silver staining. The Russian bone marrow preparations were used directly, while the bone marrow specimens from Argentinian donors were incubated for 24 hours at 37 degrees C in F-10 medium with 15% fetal bovine serum. The slides were silver stained by the one step method of Howell and Black with slight modifications. Thirty metaphases with clearly defined D and G group chromosomes were scored for the numbers of AgNORs. All metaphases that were adjacent to silver stained interphase nuclei were analysed to assess the percentage of AgNOR positive mitoses. The Kruskal Wallis test and Kendall's rank correlation coefficient (rK) were used to assess the relation between age and the percentage of AgNOR positive cells.

RESULTS

The mean numbers (SE) of AgNORs per metaphase were 5.06 (0.17) and 5.56 (0.23) for the Russian and Argentinian groups, respectively, with no significant differences between the two groups. The common percentage of AgNOR positive cells decreased significantly as a function of age, with an rK = -0.57 (p < 0.0012).

CONCLUSIONS

The percentages of AgNOR negative metaphases in bone marrow from healthy individuals is strongly associated with age and this may be related to age related telomere loss.

Nucleolar organizer regions in parosteal and central osteosarcomas

Silver stained nucleolar organizer regions (AgNOR) have revealed differences in the biological behavior of certain entities. This study involves a morphometric analysis of AgNOR in 6 central, classic osteosarcomas and 6 parosteal osteosarcomas. There was a statistically significant difference in the number of AgNOR per nucleus between central and parosteal osteosarcomas. Single AgNOR volume was smaller in central osteosarcomas as compared to parosteal osteosarcomas. However, this difference did not reach statistical significance. The parameter AgNOR number per nucleus revealed a cut off value such that 100% of central osteosarcoma cases lay above this value and 100% of parosteal osteosarcoma cases lay below this value. AgNOR demonstration involves a simple technique which can be performed on formalin fixed, paraffin embedded file material. Thus, it may be prudent to routinely assess AgNOR as a contributor to the determination of the pathophysiology of osteosarcomas.

AgNOR mark epithelial foci in malignant transformation in hamster cheek pouch carcinogenesis

Hamster cheek pouch mucosa is an accepted model of oral carcinogenesis. We herein examined the value of morphometric evaluation of silver-stained nucleolar organizer regions (AgNOR) in the detection of epithelial foci in malignant transformation following dimethyl-1,2-benzanthracene-induced carcinogenesis of hamster cheek pouch. AgNOR-related parameters were analyzed at different stages of the process of carcinogenesis (control epithelium, epithelium with no unusual microscopic features, "dysplastic" epithelium, exophytic and endophytic carcinomas). Morphometric evaluation of AgNOR revealed incipient cellular alterations which were not evident in routine preparations and contributed to the characterization of different stages of carcinogenesis in this model.

Semi-automatic quantitation of nucleolar organizer regions in non-Hodgkin's lymphomas

Nucleolar organizer regions may be useful in the diagnosis and classification of non-Hodgkin's lymphomas. In this study of 46 cases we applied morphometric analysis with quantitation of physical descriptors of the nuclear profile (area, perimeter) and both number and area of stained nucleolar organizers therein enclosed to a series of lymphomas and benign lymphoid infiltrates. While nuclear outlines were manually traced small organizer regions within the nuclear profiles were semi-automatically outlined by a thresholding procedure subjected to manual override. This results in determination of number, area and perimeter of organizer regions. Data were corrected for section thickness effects and a stereologic (three-dimensional) analysis was additionally performed. We found an increase in mean number and area of nucleolar organizers per nucleus in high grade lymphomas compared to benign infiltrates and lower grade lymphomas. Volume and thickness corrected data showed a decrease in organizer number with concomitant increase in organizer volume in the higher grade lymphomas. Multivariate analysis of the cases, previously classified histologically, showed that clear resolution could be obtained, on the basis of physical descriptors, both between as well as within groups of the three tumor grades.

Nucleolar organizer regions as markers of incipient cellular alterations in squamous epithelium

Transcriptionally active nucleolar organizer regions identified by silver staining (AgNOR) vary in number with cellular activity and/or malignant transformation and have been used as a diagnostic tool. A morphometric study of AgNORs was performed in an experimental model of irradiated squamous epithelium (Wistar rat sole skin) 4, 8, and 14 hours and 1, 2, 5, and 7 days post-irradiation with 50 Gy of x-rays. A statistically significant and progressive rise in AgNOR average volume of up to 238% and reduction in AgNOR number/nucleus of up to 40% were detected as a function of post-irradiation time. A statistically significant 46% increase in AgNOR volume was detected as early as 8 h post-irradiation, when no histological changes were observable in routine preparations. These results suggest that AgNORs may be useful as a quantitative marker of incipient changes in cellular activity and caution against the indiscriminate use of AgNORs in the follow-up of lesions which may have been exposed to radiotherapy. Furthermore, this study suggests the possibility of using AgNORs as a sensitive biological dosimeter in cases of uncontrolled exposure to radiation.

Proliferating cell nuclear antigen (PCNA) and nucleolar organiser regions in Hodgkin's disease: correlation with morphology

AIM

To define the distribution of proliferating cell nuclear antigen (PCNA) and silver staining nucleolar organiser regions (AgNORs) in Hodgkin's disease.

METHODS

PCNA was shown in a series of 34 cases of Hodgkin's disease using immunohistochemical methods. In a second series of 46 cases the AgNOR technique for interphase nucleolar organiser regions was studied. Both series comprised routinely fixed and processed paraffin wax sections of three main Rye subtypes.

RESULTS

In all cases, regardless of Rye subtype, most Sternberg-Reed cells and mononuclear Hodgkin cells showed nuclear PCNA immunoreactivity and such cells had 15 or more AgNOR sites. The Hodgkin cells had, in general, about half the number of AgNORs seen in Sternberg-Reed variants.

CONCLUSIONS

These data support the notion that Hodgkin's disease can be regarded as a high grade lymphoma, the large Hodgkin's and Sternberg-Reed cells being the (PCNA positive and AgNOR rich) neoplastic elements with high proliferative capacity. A smaller proportion of the associated cells also showed evidence of proliferation.

High incidence of ectopic nucleolar organizer regions in human testicular tumors

Eight primary testicular germ cell tumors, one teratocarcinoma cell line, and one Leydig cell tumor were studied to determine the importance of modifications of the nucleolar organizer regions (NORs) in human testicular tumors. Cytogenetic analysis after silver staining showed active ectopic NORs in two primary embryonal carcinomas (EC) in the cell line and in single cells of each of two seminomas (S). In one EC, an ectopic NOR was localized to chromosomal region 1q4; the others were on unidentified rearranged chromosomes. All tumors in which ectopic NORs were observed were hyperdiploid and possessed marker chromosomes typical of human germ cell tumors. Quantitative DNA analysis was performed on three tumors: a teratocarcinoma (TC) and the Leydig cell tumor, which had provided no analyzable mitoses, and a seminoma which was cytogenetically diploid. In all three cases, the major populations were hyperdiploid. The results, in combination with those of an earlier study, provide evidence that active ectopic NORs are common in human testicular tumors.

Expression of silver-stained nucleolar organizer regions is coupled to cell cycle in rat thymic cells

To directly analyze the relationship between the expression of silver-stained nucleolar organizer regions (AgNORs) and cell proliferation, thymic cells from newborn rats were separately sorted at the G0-G1-phase and early-mid and late-mid S-phase of the cell cycle according to their DNA content. Different AgNOR-derived parameters (mean area and numbers of AgNORs per cell and mean AgNOR-particle area) were evaluated after silver staining of cytospins. A linear correlation was observed between the mean area and numbers of AgNORs per cell, both parameters increasing progressively from G0-G1-phase to early-mid and late-mid S-phase. An increase of the mean AgNOR-particle area was also seen between G0-G1 and S-phase but this was not significant along the S-phase. A bias on the selection of S-phase cells linked to intrathymic maturation can be ruled out as S-phase cells labeled with bromodeoxyuridine were found throughout the thymus, and, moreover, the analysis of the frequency distribution of nuclear area did not show a bimodal pattern. It is concluded that the expression of AgNORs--evaluated as AgNOR area/cell or AgNOR numbers/cell--is causally or indirectly coupled to DNA synthesis and, thus, AgNORs can be considered as a cell proliferation marker.

Nucleolar organizer regions in acute and chronic leukaemias

A silver staining technique for nucleolar organizer regions (NORs) has been applied to bone marrow biopsies of various types of acute and chronic leukaemias. This method could be easily evaluated on resin-embedded bone marrow obtained from acute lymphocytic leukaemia (n = 12), acute myelogenous (n = 16), chronic lymphocytic (n = 16) and chronic granulocytic (n = 20) leukaemia. A significant difference (p < or = 0.1) was only found between the AgNOR numbers in nuclei of lymphocytes from acute and chronic leukaemia (mean of 1.23 to 1.40 and 1.58) and those of cells from acute and chronic myelogenous leukaemia (from a mean of 5.00 to 9.17 per nucleus). However, no significant difference was observed among cells of various types of acute and chronic myelogenous leukaemias, despite of their markedly higher staining intensity and proliferative activity. The greatest mean of AgNOR numbers was counted in monoblasts of acute myelomonocytic leukaemia. It is suggested, that higher AgNOR counts in nuclei of more malignant leukaemic cells are in parallel with their mitotic activity and could be related to their elevated cell turn-over.

Correlation of nucleolar organizer regions and nuclear morphometry assessed by automatic image analysis in breast cancer with aneuploidy, K167 immunostaining, histopathologic grade and lymph node involvement

Silver-stained nucleolar organizer regions (AgNORs) in human breast carcinoma were studied using a computer-assisted system of image analysis. Standardized, automatic measurements of 7 morphometric parameters (area, perimeter, shape factor, bend energy, angle, and small and large diameters) performed on paraffin sections and cell imprint were compared and correlated with nuclear morphometry, histopathological grading, tumor growth fraction, (monoclonal Ki67-immunostaining), DNA nuclear content (stoechiometric Feulgen staining) and axillary lymph node invasion. The major findings were as follows: (i) variations in AgNORs and nuclear parameters were correlated, (ii) the ratio of AgNOR area/nuclear area was significantly different in low and high grade tumors, (iii) mean AgNOR parameter values increased significantly with the tumor growth fraction and tumor hyperploidy and were significantly higher in patients with axillary lymph node metastases and (iv) AgNOR evaluation was more accurate for cell preparations than for tissue sections.

Nucleolar organizer regions in pituitary gland adenomas

Nucleolar organizer regions are DNA segments concerned with the synthesis of ribosomal RNA (rRNA). Some specific proteins related to NORs can be demonstrated by a silver technique and are then referred to as Ag-NORs. The mean number of Ag-NORs per cell has been used as a marker of cell proliferation in recent years and there is some evidence to suggest that Ag-NOR counts can be used to differentiate between normal and neoplastic cells. Paraffin block sections of 42 pituitary gland adenomas and 24 normal adult pituitary glands have been examined using the Ag-NOR staining technique. Touch imprints of nine adenomas and 12 normal adult pituitary glands were also examined using the same Ag-NOR staining technique. Using light microscopy at x2000 magnification, the Ag-NORs were located as black dots in the cell nuclei and the mean number of Ag-NORs per cell was determined. No significant difference was observed between blocked sections and imprints of adenomas or between imprints and paraffin sections of normal glands. However, a significant difference was observed between the mean number of Ag-NORs in pituitary gland adenomas and normal glands in paraffin block sections and touch preparations (P less than 0.001). The modified Ag-NOR technique can be a useful aid in the differential diagnosis between normal pituitary gland tissue and pituitary adenomas, especially during surgical operations.

Morphometric study of nucleolar organizer regions in human oral normal mucosa, papilloma and squamous cell carcinoma

A morphometric study of nucleolar organizer regions (NOR) was performed to analyze their distribution, volume, number and shape in the different strata of human normal oral mucosa epithelium and papilloma and in squamous cell carcinoma employing microphotographs of silver-stained paraffin sections. The different NOR-related parameters evidenced significant differences between normal mucosa, papilloma and squamous cell carcinoma. The functional polarity of normal mucosa epithelium and of papilloma is also evidenced in terms of NOR-related parameters. The discriminative value of certain NOR parameters was demonstrated.

Argyrophylic nucleolar organiser regions (AgNOR's) as a prognostic indicator in breast carcinoma

Silver staining nucleolar organiser regions (AgNOR's) were determined in archival histological specimens of breast carcinoma. Representative samples from forty-eight female patients were counted manually for AgNOR's--median 3.85 (range 1.1-10.2 AgNOR's per cell). Taking the median value of 3.85 as a cutoff, the patients were divided into two groups: A = Those with AgNOR counts > 3.85; B = Patients with AgNOR counts < or = 3.85. The 5 year survival was 21% in group A and 85% in group B (p < 0.001). There was no significant correlation between AgNOR's and tumour size, lymph node status, tumour grade, menopausal status and oestrogen receptors. We conclude that nucleolar organiser regions may be useful as a prognostic indicator in breast carcinoma especially in patients in whom other prognostic information is unavailable.

AgNOR (nucleolar organizer regions) staining in malignant melanoma

Nucleolar organizer regions (NORs) are loops of ribosomal DNA seen in nuclei, which are demonstrable as black dots (AgNOR) in tissue sections by silver (Ag) colloid staining. The number of such AgNORs is correlated with cellular activity and is an indicator of the degree of malignancy. In this study, 76 melanocytic lesions were analyzed by AgNOR staining, and the clinical and histopathological characteristics of malignant melanoma and melanocytic nevi were considered. Although the AgNOR counts for melanocytic nevi were significantly different from those in malignant melanoma, an obvious overlap between them was detected. The number of AgNORs in melanocytic nevi per cell was usually 1 or 2. On the other hand, the number of AgNORs per malignant melanoma cell was variable. Morphologically, malignant melanoma cells often showed dispersal of AgNORs throughout the nucleus as well as multiple nucleoli containing clustered AgNORs, whereas melanocytic nevus cells tended to have a regular nucleolus with tightly clustered AgNORs. The correlation between AgNOR count and pathological staging was uncertain, but a slight correlation between AgNOR count and thickness of the primary lesion was obtained. However, the AgNOR count in malignant melanoma was not a prognostic factor for the disease. Therefore, the AgNOR method is difficult to use for differential diagnosis between benign pigmented lesions and malignant melanoma. Nonetheless, an AgNOR count of more than two per cell favors a diagnosis of malignant melanoma.

Variations in the occurrence of silver-staining nucleolar organizer regions (AgNORs) in non-proliferating and proliferating tissues

Previous studies on the subject of silver-staining nucleolar organizer regions (AgNORs) as indicators of precise proliferative status of tissues have sometimes resulted in ambiguity. The studies, however, have most frequently addressed themselves to the prognosis of neoplasias, with the aim of using AgNORs principally to distinguish between benign and malignant tumours. This investigation was to determine a base-line relationship of AgNOR clusters to proliferation and thus concentrated on normally proliferative tissues and conditionally renewing tissues after appropriate stimulation. Two murine transplantable tumours were also examined as examples of frank malignancy. As an example of the former, variations in AgNOR clusters were noted in the small intestine of man, mouse, and rat. The conditionally renewing systems of liver, prostate, and salivary glands were stimulated into proliferation by two-thirds partial hepatectomy, castration followed by treatment with testosterone, and isoproterenol treatment, respectively, in rat models; the murine sarcoma SaF and carcinoma CaNT provided relatively simple malignant tumours for AgNOR investigation. Proliferation was monitored by noting labelling indices after injection with bromodeoxyuridine (BrdUrd) in vivo followed by immunocytochemical visualization of S-phase cells. In all tissues, an increase in the size of AgNOR clusters rather than their number correlated positively with elevated labelling, particularly with the emergence of silver-staining regions of 2-3 microns visible diameter. Thus, increased AgNOR cluster size (diameter) as representative of AgNOR cluster/nucleolus volume was found to be dependent on proliferative activity in a range of normal and neoplastic tissues.

Argyrophilic nucleolar organiser region (AgNOR) staining in normal bone marrow cells

Fifteen normal bone marrow aspirates were stained with the agyrophilic nucleolar organiser region (AgNOR) method. The results of the specific staining AgNORs as well as nuclear and cytoplasmic staining were analysed. A system was devised to characterise precisely the AgNORs present in the nuclei of bone marrow cells. Particular types of bone marrow cells had a characteristic AgNOR and non-AgNOR staining pattern. The bone marrow cells were identified easily and reliably with AgNOR staining and the method was especially useful for lymphocytes, plasma cells, erythroid cells, basophils/mast cells, monocytes and cells containing haemosiderin. The immature haemopoietic cells exhibited more and larger AgNORs than the more mature cells. It is concluded that AgNOR staining can be used to study bone marrow cells by providing additional information when used in conjunction with conventional stains.

Silver-binding nucleolar organizer regions (AgNORs) in benign and malignant breast lesions: correlations with ploidy and growth phase by DNA flow cytometry

Silver-binding nucleolar organizer regions (AgNORs) have been counted in sections of routinely processed paraffin-embedded tissue blocks and have been shown to assist in the distinction between benign and malignant lesions. We have examined 214 benign and malignant breast lesions by this method. The AgNOR counts were fibroadenomas 1.87 +/- 0.20 (mean +/- SD; n = 39), papillomas 1.92 +/- 0.21 (n = 28), sclerosing adenosis 1.96 +/- 0.24 (n = 23), epitheliosis 2.21 +/- 0.30 (n = 38), lobular carcinoma in situ 2.67 +/- 0.54 (n = 9), intraduct carcinoma 3.75 +/- 1.33 (n = 37), and invasive carcinoma 4.22 +/- 1.18 (n = 40). However, the counts in 25-30 per cent of epitheliosis lesions and intraduct carcinomas overlapped in the region of 2-3 AgNOR dots per nuclear profile. The AgNOR counts in carcinomas were also compared with ploidy and growth phase fractions (S + G2 + M%) by flow cytometry. Thirty-three of the 46 cancers with counts over 3 AgNOR dots per nuclear profile contained aneuploid cells (greater than 10 per cent of the total), whereas 8 of the 12 with counts below 3 comprised diploid cells only (P less than 0.05). Similar trends were noted with regard to growth phase fractions which were 19.15 per cent +/- 12.31 and 13.98 per cent +/- 5.55, respectively, for the two groups (P greater than 0.10). We conclude that this method alone does not offer a reliable histological discriminant for malignancy in the breast. However, AgNOR counting may provide information on breast cancer prognosis supplementary to that obtained from DNA flow cytometric analyses.

Computer-assisted image analysis of silver staining in normal and leukemic bone marrow

Computer-assisted image analysis was used to quantitate the amount of silver staining in interphase nuclei of bone marrow cells from acute lymphocytic leukemia (ALL) patients. When we compared the data obtained for the interphase nuclei with that obtained for the metaphase spreads, we found a strong correlation between the fraction of bone-marrow metaphases stained positively with silver, the average number of silver-positive nucleolus organizer regions per metaphase, and the amount of silver staining in the interphase nuclei. Computer-assisted image analysis of interphase nuclei can be used, therefore, to differentiate normal from ALL bone-marrow samples.

Silver staining of nucleolar organizer regions in malignant melanoma and melanotic nevi

The recently described method of staining nucleolar organizer regions (NOR) with colloidal silver nitrate was applied to the paraffin sections of five junctional nevi, 13 compound nevi, seven Spitz nevi, nine cellular blue nevi, 11 dysplastic nevi, seven malignant lentigines, 12 superficial spreading melanomas, and 14 secondary melanomas. There was a significant difference between the pooled silver-NOR (AgNOR) numbers of the 45 benign lesions (mean, 1.22; SD, 0.51) and the 33 melanomas (mean, 9.18; SD, 4.05) by t test analysis (P less than .01). The difference was striking enough to be recognized on casual microscopic examination, suggesting that AgNOR staining may be a useful technique to help separate melanocytic nevi from malignant melanomas.

Differential nucleolus organizer activity in normal and leukemic bone marrow

A cytochemical technique that uses silver nitrate staining has been used to study the nucleolus organizer activity in bone marrow cells from 13 patients with acute lymphocytic leukemia (ALL), 11 patients with chronic myelogenous leukemia (CML), 7 patients with acute myelogenous leukemia (AML), and 4 healthy persons. Our results indicate that the nucleolus organizer region (NOR) activity was significantly lower in the control group than in the ALL patients. The NOR activity level was significantly lower in both the CML patients in chronic phase and the AML patients than in the ALL group and similar to the control group. These disease-related differences in NOR activity as detected by silver staining can be used as diagnostic procedure in evaluating human leukemias.

Nucleolar organizer regions in Spitz nevi and malignant melanomas

Nucleolar organizer regions (NOR) are loops of DNA that transcribe ribosomal RNA; they can be easily identified in formalin fixed paraffin embedded tissue using a silver (Ag) method. It has been suggested that the number of AgNOR per cell can differentiate between benign and malignant melanocytic lesions of skin. We have studied 29 Spitz nevi (SN) and 39 invasive malignant melanomas (MM) by the same silver method. SN showed between 1.0 and 1.6 AgNOR per cell with a mean of 1.2. MM counts ranged from 1.2 to 4.2 with a mean of 2.0. It is concluded that the AgNOR method cannot reliably differentiate SN from MM; however, a count of more than 2.0 AgNOR per cell would favor a diagnosis of MM rather than SN.

Temporal variation in nucleolar organizer region expression in bone marrow cells of individuals with leukemia

Silver staining was used to study nucleolar organizer region (NOR) expression in bone marrow cells obtained at two or, in one case, three time points from each of six leukemia patients. Using three measures of silver positivity, we observed that NOR expression was influenced by both metaphase stage and time. Silver positivity decreased significantly from one metaphase stage to the next, from prometaphase through late metaphase. When this variable was controlled for, significant changes in NOR activity were documented in comparisons between disease stages in the patients examined. However, patterns of NOR expression were not consistently associated with disease stage. These results indicate that in previous reports both the metaphase stage effect and the temporally changing nature of NOR activity have, as unrecognized variables, influenced observations of heterogeneity in NOR expression.

Spontaneous in vitro neoplastic evolution of cultured Chinese hamster cells. Nucleolus organizing region activity

Silver staining to demonstrate active nucleolus organizing regions (NORs) was performed at four different stages of the spontaneous tumorigenic progression in vitro of Chinese hamster WCHE/5 cells. The number of active NORs increased for fully transformed, highly tumorigenic, late passage cells. The increase of NOR material was due to additional NOR-bearing chromosomes or chromosome arms, i.e., trisomy 5, trisomy 8, and the marker chromosome i(3q). Intermediate stages of the neoplastic evolution showed changing patterns of NOR activity, but not an overall increase. We postulate that the increase of active rDNA enhances cell growth and provides undefined selective advantage, and that this supports our previous conclusion that selectable karyotype changes provide competitive advantages rather than being essential for neoplastic evolution in vitro.

Cytogenetic analyses of somatic chromosomes in a transplantable monomyelocytic leukemia in BALB/c mice

In vivo cytogenetic analyses have been performed using G-, C-, and nuclear organizing region (NOR)-banding techniques, and sister chromatid exchanges (SCE) on a transplantable monomyelocytic leukemia (MML) initially induced in female BALB/c mice by the Rauscher leukemia virus (RLV). Centromeric associations have been found to be greatly increased in MML transplanted mice. Transplantability of the disease has been demonstrated at the cytogenetic level by the presence of female cells in males transplanted with MML cells. G-banding analysis has shown the existence of a marker deleted chromosome 18 in all tissues examined (bone marrow, spleen, and peripheral blood) restricted to female transplanted cells. The NOR-banding analysis has shown a slight increase in the number of Ag-NOR sites per metaphase in MML transplanted mice compared with controls and the existence of an extra chromosome having NOR in MML transplanted mice. No differences were found in C banding between controls and MML transplanted mice. In MML transplanted males, female transformed cells showed a significant reduction in SCE frequency compared with host male cells or controls.

A comparison of nucleolar organizer region staining and Ki-67 immunostaining in non-Hodgkin's lymphoma

Eighty cases of non-Hodgkin's lymphomas were examined independently using the monoclonal antibody Ki-67 and an argyrophilic method for the demonstration of nucleolar organizer regions. The evidence that Ki-67 immunoreactivity may be used as a marker of cell proliferation is described and the nature of nucleolar organizer regions reviewed. The proportion of tumour cells with nuclear Ki-67 immunoreactivity and the mean number of nuclear organizer regions are shown to be linearly related (r = 0.86, P less than 0.001) although some scatter was observed. These data suggest that the mean number of nucleolar organizer regions may reflect the cellular kinetics of a tumour. This study also provides further evidence supporting the thesis that the mean nucleolar organizer region score is related to the histological grade of non-Hodgkin's lymphoma. Ki-67 immunostaining and nucleolar organizer region staining would seem to provide comparable data, at least in non-Hodgkin's lymphoma, but the latter method has the advantage of being applicable to conventionally fixed and processed paraffin sections.

Effect of differentiating agents on nucleolar organizer region activity in human melanoma cells

A human cell line established from a metastatic melanoma had both multiple numerical and structural chromosome aberrations including one to two copies of a submetacentric marker chromosome with an insertion of an active nucleolar organizer region (NOR). Treatment of this cell line with retinoic acid (RA) induced morphologic differentiation and reduced the cellular saturation density concomitant with a significant decrease in Ag-NOR activity. RA-treated cells grown in the absence of this differentiating agent, however, displayed a return to normal Ag-NOR activity, indicating the effect of this chemical on ribosomal genes is reversible.

The activity of nucleolar organizer regions of human bone marrow cells studied with silver staining. II. Acute leukemia

The activity of nucleolar organizer regions (NOR) in chromosomes and interphase nuclei of bone marrow cells from 11 adult patients with acute lymphoblastic leukemia (ALL), 35 patients with acute nonlymphoblastic leukemia (ANLL), and eight healthy donors has been studied with silver nitrate staining. PHA-stimulated lymphocytes of the same individuals were used as standards of the maximum silver-staining patterns for each person. In 90% of patients with acute leukemia the average number of Ag+NOR in metaphases was lower when compared with that of PHA-stimulated lymphocytes. A variable expression of NOR was observed within the cell population and between individual patients. The populations tested showed high heterogeneity in relation to the content of Ag-negative mitoses. Ag+NOR per metaphase and the content of Ag-negative mitoses in bone marrow did not differ between patients with ALL and ANLL. Differences in the staining pattern in leukemic cells are discussed.

Silver bands in chronic granulocytic leukemia. II. The Philadelphia chromosome

To test if rRNA gene activity in the Philadelphia (Ph) chromosome nucleolar organizing regions (NOR) differs from other NOR we scored silver banding patterns in leukemic cells of 32 patients (one patient was sampled twice) in the chronic phase of chronic granulocytic leukemia. The average number of bands per NOR in banded cells of these patients was 0.40 +/- 0.06 for the Ph NOR, not significantly different from the 0.41 +/- 0.02 per D chromosome NOR or the 0.41 +/- 0.04 per G. Across the 33 cases, the number of different Ph NOR banded in at least one cell (23 of 33, 70%) was also closely similar to the cumulative maximum number of chromosome D NOR banded per cell (137 of 198 banded, 69%) and G NOR banded (67 of 99, 67%). We conclude that the activity of rRNA genes in Ph NOR is closely similar to that of the other nine NOR in each CGL cell. In situ hybridization of 3H-labeled complementary rRNA to NOR of two patients revealed that the mean number of Ph NOR grains fell within the range of the other NOR. Also, grain distributions across the NOR of leukemic cells closely matched those of stimulated lymphocytes. Thus, a limited sampling has shown no evidence for consistent differences or changes in the rRNA gene number of Ph NOR.

Silver-stained nucleolar organizer regions in bone marrow cells and peripheral blood lymphocytes of Philadelphia chromosome-positive chronic myelocytic leukemia patients

Silver-stained nucleolar organizer regions (Ag-NOR) in bone marrow cells and/or phytohemagglutinin-stimulated peripheral blood lymphocytes were compared between six normal healthy persons as controls and 22 Philadelphia chromosome (Ph)-positive chronic myelocytic leukemia (CML) patients, to examine if any disease associated changes occur in the expression of Ag-NOR. Although the frequency of Ag-NOR-positive cells and the number of Ag-NOR per cell were generally greater in lymphocytes than in bone marrow cells in both controls and CML patients, the Ag-stainability of these cell types in CML patients was considerably heterogeneous, compared with that found in controls. The peripheral lymphocytes of CML patients in the chronic phase, but not in the blastic phase, exhibited a significantly lowered Ag-stainability when compared with those of controls. while no such difference was observed between bone marrow cells of controls and leukemia patients in both phases of CML. In the blastic phase, however, the occurrence of Ag-NOR on the Ph of CML bone marrow cells was significantly less than expected. The present findings are discussed in relation to the existing data on the Ag-NOR expression in both normal and neoplastic cells.

Ag-NOR staining in human chromosomes: differential staining in normal and leukemic bone-marrow samples

A silver staining technique developed by Goodpasture and Bloom (1975) stains a specific protein associated with the activity of ribosomal cistrons during the preceding interphase. By counting the number of chromosomes with darkly stained nucleolus organizer regions (NORs), the number of active NORs per metaphase can be determined. A comparison of NOR activity in bone-marrow cells from leukemic patients in different stages of disease with that of bone marrow from normal, healthy individuals was conducted and differential NOR activity was detected. The control group showed significantly lower NOR activity when compared with a group of patients with acute lymphocytic leukemia (ALL). These preliminary data indicate that this simple cytochemical technique can be effectively used to differentiate between normal and ALL bone-marrow samples.

Nucleolar organizer regions in patients with precancerous and cancerous lesions of the uterine cervix

Nucleolar organizer regions (Ag-NORs) were studied in patients with cervical precancerous and cancerous lesions along with controls. The data revealed a statistically significant decrease of Ag-NORs in cancer patients, as well as in women with severe precancerous lesions as compared with controls. A similar decrease in the amount of Ag-staining was also observed in both cancer and severe dysplasia cases. The study suggests a possible relationship of Ag-NOR activity to malignancy.

The activity of nucleolar organizer regions of human bone marrow cells studied with silver staining. I. Chronic myelocytic leukemia

The activity of nucleolar organizer regions (NORs) in chromosomes and interphase nuclei of bone marrow (BM) cells from 21 patients with chronic myelocytic leukemia (CML), including seven patients at the time of blastic crisis (BC), has been studied with silver nitrate staining. The average numbers of Ag-NOR per metaphase in PHA-stimulated peripheral blood lymphocytes from patients with CML and normal individuals were 7.1 +/- 0.3 and 7.4 +/- 0.1, respectively, indicating no statistical difference between them. Those in BM cells from patients with CML, as in the normal donors, were more heterogeneous compared to PHA-stimulated lymphocytes, and most of the metaphases (up to 67%) did not contain silver-stained NORs. The average number of Ag-positive NORs in BM mitoses from untreated patients in the chronic phases of CML and from those in the BC were similar (4.9 +/- 0.3 and 4.8 +/- 0.4, respectively). As for NORs of the Ph chromosome, they were Ag-positive in the majority of patients, including 9 of 14 in the chronic phase and 3 of 7 in the BC. This article contains some data in support of the authors' previous assumption regarding the correlation between BM Ag-NOR patterns and the degree of maturity of the cells tested in mitosis.

Comparison of metaphase and interphase nucleolar activity in Hela-CCL2 cells and PHA-stimulated human lymphocytes

Metaphase and interphase nucleolar activity in cultured Hela-CCL2 cells and PHA-stimulated human lymphocytes have been studied with silver nitrate staining. In metaphase, we examined the relationship between the actual number of active NORs (AgNORs) and total number of NOR-bearing acrocentrics. Interphase silver staining over the nucleus was analyzed cytodensitometrically and morphologically. From all investigations, Hela-CCL2 cells and lymphocytes were shown to have similar levels of nucleolar activity. Our results suggest that there is a form of regulation of nucleolar activity in malignant Hela-CCL2 cells as compared to PHA-stimulated human lymphocytes.

Correlation of differentiation state and silver staining of nucleolar organizers in the promyelocytic leukemia cell line HL-60

We have applied nucleolar organizer region (NOR) silver staining to the promyelocytic leukemia cell line HL-60, before and after dimethylsulfoxide (DMSO) mediated differentiation. The results demonstrated a gradual suppression of rDNA transcription during terminal maturation of these bone-marrow-derived cells and support our hypothesis that there are characteristic NOR staining profiles for different bone marrow cell types.

Heterochromatin and nucleolus organizer regions in cells of patients with malignant and premalignant lymphatic diseases

Peripheral blood lymphocytes (short-term cultures) and permanent lymphoid cell lines (long-term cultures) of patients with Hodgkin disease (5), lymphoma (1), plasma cell leukemia (1), angioimmunoblastic lymphadenopathy (1), and infectious mononucleosis (3) were investigated for C-band variants and nucleolus organizer region (NOR)-activities by C-banding and silver-staining, and compared to those of healthy adults (5) and newborn children (3). Heterochromatin polymorphisms were found in malignant diseases (33%) as well as in controls (29%). In the lymphoma patients, heterochromatin of class 3 (Patil and Lubs 1977) was seen more frequently than in the controls (83%:57%). No marker C-band variants could be detected in any of the lymphatic diseases. There was no difference in the heterochromatin polymorphism between short-term cultures (predominantly T-cells) and long-term cultures (B-cells), and there was little but inconsistant difference in the NOR-activities. Silver-staining showed differences between healthy adults (8.8 AgNORs; SD:0.5) and newborn children (6.9; SD:0.4). In the lymphoma patients we found 8.3 (SD:0.7) AgNORs. Thus, using silver staining there was no detectable increase in the number of active NORs in cells of patients with malignant diseases as an expression of increased nucleolus activation in malignancies. The remarkably low NOR-activity in infectious mononucleosis (6.7; SD:1.0) may reflect an influence of acute virus infection (Epstein-Barr virus) on NOR-activity.

Silver bands in chronic granulocytic leukemia: I. Increased banding associated with blastic transformation

We have tested the proposal that the level of silver banding in leukemic cells of Ph1 + chronic granulocytic leukemia (CGL) patients increases as the disease progresses. Blood and/or bone marrow cells from 14 patients were cultured for 24 hr before banding. In all but one case, there were two populations of mitoses, those with silver bands on their nucleolar organizing regions (NORs) and those without. The percentage of cells that banded was higher, on average, in cultures from 7 patients in blastic transformation (80%) than in 8 chronic cases (36%) or in one accelerated phase (49%). Also, the mean number of NORs stained in banded cells was higher in blastic phase (6.9) compared with chronic phase cells (4.4). Hyperdiploid cell lines were present in four cases of myeloblastic transformation. All such cells were silver banded, and the mean fraction of NORs banded in them was relatively high. An increase in silver banding with time was shown in two of the patients. It seems that silver banding does increase in CGL cells as the disease progresses. This may arise either through an increase in the rate of ribosomal RNA synthesis in leukemic cells present in the blastic phase or possibly by a decrease in the rate of degradation (or processing) of newly synthesized rRNA.