Abstract:
This descriptive retrospective study was performed in Khartoum to assess the
expression of NORs in hepatocellular carcinoma as compared to liver cirrhosis in
Sudanese patients, to find out whether there is statistically significance differences in
mAgNORs between the two cases as well as in different grades of hepatocellular
carcinoma.39 paraffin blocks representing the cases of hepatocellular carcinoma ,were
taken from hospital records in three different governmental centers in Khartoum, as
well as 16 cases of liver cirrhosis. A minimum of three sections (3μ) were taken from
each liver tissue, one section was stained routinely by haematoxylin and eosin to high-
light tissue architecture and determine the tumor grade, other histological section was
stained by silver-NOR mthod. Staining was performed on formalin-fixed, paraffin-
embedded tissue sections NOR dots were counted in 100 randomly selected
hepatocytes at ×100 oil immersion objective, and the mean count per cell was
calculated for each case.
Statistical analysis was done by using the Student T-test for unpaired data and
Spearman's correlation tests. AgNOR count results were later compared with the
histologic diagnosis.
The mean AgNORs count was 2.94 and 6.54 dots per cell in liver cirrhosis and
HCC respectively and the difference was statistically
significant (P. value less
than 0.01). The study revealed increasing mean AgNOR counts from cirrhosis to
hepatocellular carcinoma.
The hepatocellular carcinomas were graded according to the Edmondson-Steiner
histological grading system. Among the study population 23 of HCC cases was well
differentiated hepatocellular carcinoma (constituting about 58.9% of HCC cases), 13
cases were moderately differentiated carcinoma (constituting about 33.3% of HCC
cases) and 3 cases were poorly differentiated hepatocellular carcinoma (constituting
about 7.7% of HCC cases.
The mAgNOR in grade I, grade II and grade III HCC was 4.36± 1.5, 8.34±2.02
and 10.82±2.40 respectively.There was statistically significant correlation between
mAgNORS count and hitological tumor grade (P.value less than 0.05). The AgNOR
score increases with the increasing tumor grade.
