Abstract This study was conducted in the department of Pathology King Edward Medical University, from June to December to introduce the new method of AgNOR staining and its interpretation to increase its reliability. A total of 60 brain specimens were stained with modified AgNOR technique. Modified method of AgNOR staining and interpretation was an easy, reliable and reproducible alternative to traditional AgNOR techniques for evaluating proliferation activity of cells in malignant and benign brain lesions. The AgNOR dots were brighter and more clear with modified staining when compared with previous studies.

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Jagdish V Tupkari, R. E-mail: moc. This article has been cited by other articles in PMC. Abstract Aim: The aim of this study was to determine the diagnostic accuracy of routine Papanicolaou stain PAP and Silver stained Nucleolar Organizer Regions AgNOR staining in brush biopsies taken from suspected oral lesions for early detection of oral cancer. Materials and Methods: Brush biopsies were collected from macroscopically suspicious lesions of the oral cavity of 34 patients and 10 normal-aged and sex-matched controls.

Results: Sensitivity and specificity of PAP analysis in the oral smears for detection of oral cancer and normal cells was Conclusion: Based on the above facts, we conclude that brush biopsy in conjunction with AgNOR staining is an easily practicable, non-invasive, safe and accurate screening method for the detection of macroscopically suspicious oral cancerous lesions.

Because of its simple technique and high reliability for cellular proliferation, AgNOR staining in brush smears can be used as an adjunct to other routine cytological diagnoses for the early detection of oral cancer. However, further investigations with more number of study samples will be needed to establish this correlation beyond doubt. In the last few years, AgNOR analysis is being frequently used to determine the prognosis of many malignant lesions.

Many recent reports have suggested that the number of AgNORs per nucleus is related to cellular proliferation and differentiation. This finding could be useful in differentiating between normal, benign and malignant lesions. The study population consisted of 44 subjects including control , from which 88 smears two smears per subject were obtained. After thorough evaluation, 10 subjects for the control group were selected from age- and sex-matched subjects with prior consent and these subjects comprised the group I category of this study.

The 34 subjects having clinically diagnosed or suspicious of cancerous lesions excluding recurrent lesions or those who had taken some sort of treatment were grouped separately and comprised the group II category of this study. The brush biopsies were obtained and diagnosed before scalpel biopsies clarified the nature of the oral lesions histologically. The quantification of AgNOR counts was performed blindly without the knowledge of the cytological or histopathological report. Clinical procedure After thorough clinical examination and consent, the subjects were subjected to 5-min gargling and the lesional areas were wiped off of excessive saliva and surface debris using a moistened gauze piece.

Lesional areas with erythematous patches were usually preferred as collection sites. In case of highly keratotic or exophytic lesions, fissured or ulcerative areas were preferred for collecting the cells.

The head of the cytobrush cell collector was moistened with water and was then firmly held against the mucosa of the lesional area. Then, gentle pressure was applied to the brush until the bristles curled or tiny bleeding spots were evident. In this position, the brush was rolled over the lesional site and was rotated for 10 full turns.

The cytobrush cell collector was then rolled on glass slides by applying a continuous motion from one end of the slide to the other. The cells suspected to be abnormal were evaluated at higher magnifications and the location of abnormal cells was marked on the cover slip by an ink dot [ Figure 1 ].


Early detection of oral cancer: PAP and AgNOR staining in brush biopsies



Modified method of AgNOR staining for tissue and interpretation in histopathology




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