HASH(0x33ca590)

J Oral Pathol Med (2010) Background: Giant cell lesions of the jaws are considerably similar according to histopathologic characteristics yet show different clinical behaviors. These lesions include central giant cell granuloma (CGCG), aneurysmal bone cyst, Cherubism, and Brown tumor associated with hyperparathyroidism. The present study aimed to investigate AgNORs count in these lesions as a proliferative marker and to determine whether it can be used to discriminate between them or not. Methods: Forty-one cases of giant cell lesions of jaws were retrived from Oral Pathology Department (1987-2007). They included 21 cases of CGCG, eight cases of aneurysmal bone cyst (ABC), six cases of Cherubism, six cases of Brown tumor. The mean AgNORs count was calculated for all cases. To compare mean AgNORs in groups of lesions, ANOVA test was performed. Results: Mean AgNOR counts were:(0/85 +/- 0/29) in CGCG,(0/76 +/- 0/32) in ABC (0/87 +/- 0/10) in Cherubism and (0/82 +/- 0/16) in Brown tumor. A significant difference was not observed in AgNOR counts among these groups of lesions. Conclusions: Jaws giant cell containing lesions have no acceptable differences in mean AgNORs.

The goal of this study was to characterize the features of normal mucosa, mucosa in betel chewers and smokers, potentially malignant lesions and squamous cell carcinoma of oral mucosa using reflectance confocal microscopy. Oral cavity biopsies were acquired from 25 patients from College of Dental Surgery, Saveetha University who underwent screening for suspected lesions of Oral precancer and Oral cancer along with normal patients who underwent impaction. Biopsies were acquired from the clinically suspicious area and immediately placed in Dulbecco modified eagles growth medium (DMEM). Reflectance confocal images were obtained at multiple image plane depths from biopsies within 6h of excision. After imaging, biopsies were fixed in 10% formalin and submitted for routine histopathological examination by an experienced oral and maxillofacial pathologist. Reflectance confocal images were compared with histological images from the same sample to determine the tissue features which contribute to early cellular changes, image contrast and early diagnosis. The confocal images were obtained to a depth of up to 150microns on intact biopsy specimens and subsequent 3-dimensional images, keratin thickness measurements, cell measurements, cell density analysis and graphical representations were performed using Leica image analysis software. In normal mucosa keratin deposition were seen as alternating dark and bright stacks and in different cell layers the nuclei were seen as disks of varying intensities. In pre-cancerous lesions the keratin thickness and cell nuclear density were found to be increased when compared to normal controls. In OSMF cases confocal images of fibrosis show scattering from individual fibres as hyperdense areas. Oral squamous cell carcinoma cases demonstrated extensive variations in cell size, nuclear size and nuclear morphology. At cellular level, dysplastic features like increased nuclear density, increased nuclear cytoplasmic ratio, nuclear and cellular pleomorphism with loss of cohesiveness were identified in all five cases. Our results support the potential of reflectance confocal microscopy to play a significant role in clinical evaluations of oral lesions, early diagnosis of potentially malignant and malignant oral lesions and real time identification of tumour margins.

ABSTRACT : An evaluation of the cellular alterations in the smoker's oral mucosal cells was performed. Exfoliative Citology technique were applied and the cytologic smears stained with silver for quantitative analyses of Argyrophilic nucleolar organizer regions.(AgNORs). Cytologic smears were collected from two anatomic sites, mouth floor and tongue border with the purpose of relating the frequency of smoking with the quantitative analyses of the AgNORs. This study showed that the average number of AgNORs/nucleus is related with the number of cigarettes per day in the mouth floor of smoker's. These results suggest a possible relation between the number of cigarettes per day and an increase rate of cellular proliferation in the oral mucosal cells.

OBJECTIVE: To analyze cytologically the buccal mucosa of smoking and nonsmoking volunteers to determine what cellular changes are induced by cigarettes and alcohol consumption. STUDY DESIGN: In order to evaluate cellular changes induced by smoking and alcohol consumption, exfoliative cytology was used for the analysis of mucosal smears obtained from the buccal mucosa of 25 smokers and 25 nonsmokers. The number of cigarettes consumed, duration of smoking, presence or absence of alcohol ingestion, ingested alcohol dose and frequency of consumption, and most frequently used type of alcoholic beverage were determined using a questionnaire. Three smears from each individual stained by the Papanicolaou method were analyzed quantitatively and qualitatively under a light microscope by 2 experienced examiners in terms of inflammatory and dysplastic alterations and of the degree of epithelial maturation. RESULTS: Although numerous alterations were observed in smokers they corresponded up to only Papanicolaou class II and were not significantly different from nonsmokers (Mann-Whitney and chi2 tests, p < 0.05). A higher proportion of inflammatory cells (polymorphonuclear and mononuclear cells) were obtained from smokers as compared to nonsmokers, while the proportion of bacteria was similar in the 2 groups. CONCLUSION: The findings indicate that even after a short period of cigarette use and alcohol consumption, inflammatory alterations were detectable on exfoliative cytology of the buccal mucosa in a young group, demonstrating the usefulness of cytology for early detection in smokers.

Objetive. In smokers with clinically normal buccal mucosa,cytological changes such as increased keratinization, and higher nucleolar activity have been observed. In these studies the cells for cytological smears were obtained with a wooden spatula. Our objectives were to evaluate the depth of cytological smears of oral mucosa obtained with both a brush (endobrush) and a wooden spatula, and to compare the degree of keratinization and the nucleolar activity in smokers and non-smokers. Design. We obtained cytological smears of clinically normal lateral tongues of 30 smokers and 30 non-smokers using both a wooden spatula and endobrush. The samples were dyed with Papanicolaou and the AgNORs. Results. With the wooden spatula we found a greater percentage of enucleated superficial epithelial cells (P = 0.016) and deeper cells were obtained with an endobrush (intermediate cells)(P =0.035). The smokers showed a greater percentage of enucleated superficial cells with both techniques, however this difference was significantly greater with Endobrush (P=0.005). The average of AgNORs in the nucleated cells was greater in smokers(3.83) than in non-smokers (2.79)(P=0.003). Conclusion. The Endobrush allows the clinician to obtain deeper cells of bucal mucosa. Smokers with clinically normal mucosa show a greater percentage of keratinized cells and a greater nucleolar activity, suggesting that cigarette smoking influences the cellular activity of the mucosa of the lateral tongue.

Oral cytology and morphometric staining is used to identify malignant keratinocytes in oral premalignant or malignant lesions. To detect and to begin to assess changes in oral keratinocytes exposed to tobacco-derived carcinogens, which are at risk for malignant transformation, a novel method is required. The approach uses oral cytology harvested oral keratinocytes analyzed using flow cytometry (FC) for changes in DNA content, damage, cell cycle and apoptosis. Six smoker and six non-smoker oral keratinocytes were evaluated using flow cytometry in the form of laser scanning cytometry (LSC) and laser microdissection (LMD). Among smokers compared to non-smokers, the method detected and assessed DNA damage from tobacco smoke exposure quantifying an enhanced formation of DNA adducts, such as, 8-hydroxy-2'-deoxyguanine (8-OHdG) which creates oxidation lesions and benzo[a]pyrene(B[a]P), which produces a B[a]P)-N2-dG bulky adduct. Increased DNA content, aneuploidy, percentage of cells in synthesis (S) and G(2)+Mitosis (M), and apoptosis were recorded. Tissue and cell controls were used to verify these relationships. Data suggested healthy smokers were at increased risk for malignant transformation of oral keratinocytes because of the changes stated above. Using identical methods, keratinocytes exposed to the tobacco derived carcinogen, B[a]P parallel results obtained from smoke exposure indicating a direct link. Flow cytometric evaluation of oral cytology harvested keratinocytes can be used to measure exposure to tobacco carcinogens, and possibly establish a link to premalignant and malignant transformation before a lesion is noted.

OBJECTIVE: The aim of this retrospective study was to report on the diagnostic accuracy of AgNOR-analysis as an adjunctive diagnostic tool of conventional oral exfoliative cytology taken from suspicious lesions in our clinic. STUDY DESIGN: Cytological diagnoses obtained from brush biopsies of macroscopically suspicious lesions of the oral mucosa from 75 patients (final diagnoses: 53 histologically proven squamous cell carcinomas, 11 leukoplakias and other inflammatory oral lesions) and from 11 patients with normal mucosa as a negative control group were compared with histological and/or clinical follow-ups. Five smears were doubtful and seven suspicious for tumor cells in the cytologic report. Number of AgNOR's were counted in 100 squamous epithelial cell-nuclei per slide after silver-restaining. RESULTS: Sensitivity of our cytological diagnosis alone on oral smears for the detection of squamous carcinomas was 92.5%, specificity 100%, positive predictive value was 100% and negative 84.6%. The best cut-off value of the mean number of AgNOR dots per nucleus distinguishing benign from malignant cells was 4.8. The percentage of nuclei with more than three AgNORs had a cut-off level of 70%. Applying these methods to twelve doubtful or suspicious cytological diagnoses we were able to correctly establish the diagnosis of malignancy in ten cases of histologically proven cancers and to reveal benignity in two histologically proven cases. Thus we achieved a positive and negative predictive value of 100% each. CONCLUSIONS: Smears from brushings of visible oral lesions, if clinically considered as suspicious for cancer, are an easily practicable, non-invasive, painless, safe and accurate screening method for detection of oral cancerous lesions. We conclude that AgNOR-analysis may be a useful adjunct to other methods in routine cytological diagnosis of oral cancer that can help to solve cytologically suspicious or doubtful cases.

OBJECTIVE To describe the main cytological findings associated with smears collected from oral lesions of paracoccidioidomycosis and to appraise the use of cytology as a diagnostic tool for the disease. STUDY DESIGN Cytological smears and biopsies were collected from 40 lesions with a clinical suspicion of paracoccidioidomycosis. Evaluation of the sensitivity, specificity, positive and negative predictive values, accuracy and the positive likeness ratio of the oral smear when compared with the histological diagnosis, was performed. The latter is considered the 'gold standard' for comparison. RESULTS The main morphological findings were the rounded-shaped, birefringent and multiple-budded fungi, Langhans' giant cells and epithelioid cells. The following associative measures were found: sensitivity, 67.9%; specificity, 91.7%; positive predictive value, 95.0%; negative predictive value, 55.0%; accuracy, 75.0%; and positive likeness ratio, 8.14. CONCLUSION The cytological findings of paracoccidioidomycosis are characteristic and cytology is accurate in the diagnosis of the disease. Positive patients should be treated. Negative patients should be submitted to biopsy to confirm or to dismiss the diagnosis of this mycosis.

An evaluation of cellular alterations in the smoker's oral mucosal cells was performed. The Exfoliative Cytology technique was applied and the cytological smears stained with silver for the enumeration of Argyrophilic nucleolar organizer regions (AgNORs). Cytological smears were collected from two anatomic sites: floor of the mouth and tongue border, in both groups, smokers and non smokers, with a purpose of correlating the smoking habit to possible cellular alterations. The enumeration of the AgNORs showed that the average number of AgNORs is higher in smokers. There is a significant difference (P=0.0001) between smears from the floor of the mouth and from tongue border in the smoking group. In this study, no correlation between number of cigarettes, age and gender was found, but the results suggest that there might be a correlation between the smoking habit and an increased rate of cellular proliferation in the oral mucosal cells.

This is the first description of solitary phaeohyphomycosis affecting the mucosal surface. The lesion developed in the inferior lip of a 57-year-old woman. After surgical resection, histopathological examination evidenced characteristic brownish fungal structures within granulomatous-purulent inflammation. Amplification and sequencing of rDNA obtained from paraffin-embedded tissue identified Alternaria species, as the causative agent.

AIM To investigate the accuracy of histological diagnosis of oral hemangioma, oral vascular malformation and oral pyogenic granuloma according to immunohistochemical evaluation of the human erythrocyte-type glucose transporter protein (GLUT-1), and to observe the immunoexpression of this protein in oral varix. MATERIALS AND METHODS Immunohistochemistry for GLUT-1 was performed in 93 histologically diagnosed cases of oral benign vascular lesions: 17 vascular malformations, 19 hemangiomas, nine varix, and 48 pyogenic granulomas. Descriptive analyses were performed. RESULTS None of the cases of the oral benign vascular lesions evaluated were immunopositive to GLUT-1. The 19 cases histologically diagnosed as oral hemangioma that showed negative staining to GLUT-1 were reclassified as oral pyogenic granuloma or oral vascular malformations. The histological evaluation itself is not enough to obtain the correct diagnosis of oral HEM as none of the sample cases were true hemangioma. All sample cases with initial vascular malformation or pyogenic granulomas classification were negative to GLUT-1, demonstrating the accuracy of histological diagnosis of these lesions itself. Oral varix showed negative staining to GLUT-1 in blood vessels. CONCLUSIONS GLUT-1 is an useful, effective and important auxiliary marker for the diagnosis of oral benign vascular lesions. CLINICAL RELEVANCE This study showed that histological diagnosis alone is not sufficient to correct diagnoses of oral hemangioma. Moreover, immunohistochemistry to GLUT-1 is a useful and easy diagnostic method that may be used to avoid such misdiagnosis. Accurate diagnosis of these oral lesions has an important clinical relevance allowing:(1) correct management,(2) adequate communication among the multidisciplinary team (dentist, dermatologist, pediatrist, radiologist, pathologist, and surgeon),(3) understanding of the biological behavior of the lesions, and (4) facilitate the development of new therapeutic modalities. Thus, supporting the use of this marker in medical and dentistry communities is warranted.

AIM: To investigate the occurrence of apoptotic cell death in the epithelium of radicular cysts and to compare its frequency in lesions presenting a distinct functional state. METHODOLOGY: Twenty radicular cysts were selected and arranged into two groups with 10 lesions in each group: atrophic (quiescent) and hyperplastic (active) epithelium. Morphologic investigations of apoptosis were conducted by means of optic microscopy in haematoxylin and eosin slides. Immunohistochemical techniques to detect the bcl-2 protein were carried out by streptavidin-biotin-peroxidase assay. In both instances, 30 sequential high-power microscopic fields were observed to determine apoptotic (AI) and bcl-2 immunostaining (bcl-2I) indexes. The presence of AI and bcl-2I within the two groups was compared using the t-test. Correlation between the AI and the bcl-2I was investigated using the Spearman test. RESULTS: Apoptosis was detected in the epithelium of all cysts. Higher AI levels were found in lesions with an atrophic (0.17 +/- 0.19) rather than a hyperplastic (0.10 +/- 0.10) epithelium. The same was found for the bcl-2I levels (0.06 +/- 0.03 vs. 0.04 +/- 0.01, respectively). However, these differences were not statistically significant. A positive and significant correlation was found between AI and bcl-2I. CONCLUSIONS: Apoptosis was always present in the epithelium of the lesions and was more frequent in lesions with atrophic (quiescent) epithelium.

OBJECTIVES: Peripheral giant cell lesion (PGCL) and central giant cell lesion (CGCL) of the jaws have a distinct clinical behaviour. Whether such biological differences are supported by a distinct pattern of proliferation markers or cell cycle associated proteins expression is not known. Therefore the purpose of the present study was to compare the immunohistochemical expression of p53, MDM2, Ki-67, PCNA and the histochemical expression of argyrophilic nuclear organiser region (AgNOR) on PGCL and CGCL of the jaws. MATERIALS AND METHODS: Paraffin wax blocks of 14 cases of PGCL and 12 cases of CGCL were retrieved. A biotin-streptavidin amplified system was used for identification of the antigens. The AgNOR number was also evaluated. RESULTS: Ki-67 immunoreactivity was greater in the mononuclear cells of PGCL compared to CGCL. PCNA and AgNOR staining were similar in PGCL and CGCL. Prominent MDM2 immunoreactivity was observed in all tissues investigated. By contrast, there was no p53 immunoreactivity. CONCLUSIONS: Although CGCL present a more aggressive clinical behaviour, it has a decreased proliferative activity compared to PGCL. Finally, p53, MDM2, PCNA, Ki-67 immunohistochemical expression and AgNOR histochemical expression do not reflect their distinct biological behaviour.

Multiple congenital granular cell lesions occurring on the maxillary alveolar ridge and ventral aspect of the tongue were identified in a 22-day-old girl. The prevalence, histogenesis, and treatment of this lesion are discussed and the literature is reviewed.

OBJECTIVE: To study the nature of multinucleated and mononuclear cells from peripheral giant cell granuloma (PGCG). MATERIALS AND METHODS: Formalin-fixed, paraffin-embedded sections of 40 cases of PGCG were immunohistochemically stained for vimentin, alpha I-antichymotrypsin, CD68, S-100 protein, lysozyme, leucocyte common antigen (LCA), factor VIII-related antigen and muscle cell actin. Six cases of PGCG were also studied by transmission electron microscopy. RESULTS: Vimentin, alpha I-antichymotrypsin and CD68 were expressed in both the mononuclear and multinucleated giant cells. Dendritic mononuclear cells, positive for S-100 protein, were noted in 67.5% of the lesions, whereas lysozyme and leucocyte common antigen were detected in occasional mononuclear cells. Ultrastructural examination showed mononuclear cells with signs of phagocytosis and sometimes interdigitations with similar cells. Others presented non-specific characteristics and the third type exhibited cytoplasmic processes and occasional Birbeck granules. Some multinucleated giant cells showed oval nuclei, abundant mitochondria and granular endoplasmic reticulum whereas others presented with irregular nuclei and a great number of cytoplasmic vacuoles. CONCLUSIONS: Immunohistochemical and ultrastructural results suggest that PGCGs of the jaws are composed mainly of cells of the mononuclear phagocyte system and that Langerhans cells are present in two thirds of the lesions.

Severe forms of periodontal disease are frequent in patients with acquired immunodeficiency syndrome (AIDS). Linear gingival erythema (LGE) is a progressive disease described in HIV-positive patients and is considered to be an early stage of necrotizing periodontitis. Although clinical and microbiological differences are reported in LGE and non-specific gingivitis (NSG), a comparative immunopathological approach of both has not been performed yet. The purpose of this study was to compare relative populations of T-lymphocytes, B-lymphocytes, neutrophils, macrophages and IgG bearing plasma cells in gingival biopsies from sites exhibiting LGE and from sites exhibiting NSG. A biotin-streptavidin amplified system was used for identification of the following antigens: CD3 (T-lymphocytes), CD20 (B-lymphocytes), elastase (neutrophils), CD68 (macrophages) and IgG (plasma cell's secretors of IgG). The results have demonstrated decrease proportions of T-lymphocytes, macrophages and high percentage of neutrophils and IgG bearing plasma cells in LGE. In contrast with NSG, many neutrophils cells in LGE were found inside oral gingival epithelium. Our results highlight the idea that progressive periodontal disease is not only characterized by increased tissue inflammation, but, in addition, by significant changes in the proportion of specific inflammatory cells. The high number of neutrophils along the gingival epithelium is probably associated with the severe gingival necrosis reported in AIDS patients.

The authors studied 15 cases of dentigerous cysts presenting epithelial remnants in their capsule. Epithelial proliferation, mineralizations and squamous metaplasia and ameloblastomathoid differentiation were observed and analysed in relation to aging and localization. Neoplasic potentiality of the epithelial remnants were discussed and a new denomination were suggested to those lesions that presented ameloblastomathoid differentiation.

The work proposes to report a case of Squamous Odontogenic Tumor describing all clinical, radiographic and histopathological findings. A review on literature discussing the tumor etiology is presented.

The ameloblastic fibroma is an uncommon odontogenic tumour that may present an aggressive behaviour and may have the potential for malignant transformation. Despite all the efforts to clarify the pathogenesis of odontogenic tumours, the origin of the ameloblastic fibroma is still uncertain. This review focuses on the molecular pathogenesis of the ameloblastic fibroma.

Background Serous effusion smears reported as (suspicious for malignancy) pose problems in clinical management. Silver staining for argyrophilic nucleolar organizer regions (AgNOR) has proved useful in making a cytopathologic differential diagnosis between benign and malignant cells. Nucleolar organizer regions(NORs) are loops of DNA located in acrocentric chromosomes. These NORs are visualized by silver staining technique that recognizes these argyrophilia associated proteins which are increased in malignancy. Objective This study aimed to distinguish reactive mesothelial cells from malignant cells in serous effusions using these NORs. Methods A total of 174 serous effusions received at the Department of Pathology, TUTH, during a period of one year were included in the study. Smears were studied by conventional Papanicolaou and Giemsa stains. AgNOR counts, variation in size and dispersion of AgNOR dots in smears were graded and compared in malignant and non-malignant effusions. Results Mean AgNOR counts of 10.43+\-0.73 and 10.21+\-0.51 in malignant peritoneal and pleural effusions, respectively, were significantly (p < 0.0001) greater as compared with counts of 2.12 +\- 0.54 and 2.11 +\- 0.54 in non-malignant effusions. The AgNORs were irregular in shape in malignant effusions whereas they were comparatively larger, single dots in benign effusions. AgNOR size and dispersion were of higher grade in significantly greater proportion of malignant as compared with non malignant effusions (p < 0.0001). Of the cytologically suspicious samples, nine were in the malignant range and one was in the benign range. Conclusion AgNOR study appears to be clinically useful as an additional diagnostic tool for use in serous effusion when the cytologic diagnosis is difficult.

UNLABELLED CONTEXT AND AIMS: The oral cavity is the most predominant location in the head and neck region for primary malignant epithelial tumors. Oral cancer is estimated to be the sixth most common malignancy. Early recognition is imperative for successful treatment and good prognosis. Exfoliative cytology is a simple and reasonably effective technique for rapid initial evaluation of a suspicious oral lesion. The present study was conducted to determine the reliability of acridine orange fluorescence microscopy for cytodiagnosis as a more rapid and easier method for the final evaluation of the cytological specimen. MATERIALS AND METHODS Smears were collected from 20 individuals with oral lesions suspicious of malignancy, oral lesions not suggestive of malignancy and normal buccal mucosa. One smear was stained with Papanicolaou stain and another one with acridine orange stain. The differences in the study group and control group were compared by means of the χ2 (Chi-square) test. The results were considered statistically significant whenever P was <0.05. RESULTS The acridine orange fluorescence stain reliably demonstrated malignant cells based on the differential fluorescence - a cytochemical criterion. The efficacy of the stain was higher than the conventional Papanicolaou stain in screening of oral lesions suspicious of malignancy. However, the acridine orange fluorescence stain did not differentiate effectively between malignant cells and rapidly proliferating cells, as the technique is based on the nucleic acid content. CONCLUSION The fluorescent acridine orange method can be used reliably for the screening of carcinomas and it is especially helpful in the follow-up detection of recurrent carcinoma in previously treated cases.

In recent years, important advances have been made in the diagnosis of diabetes mellitus, and new strategies have been put forward for its treatment. The purpose of this study was to analyze the cytomorphometric changes and glycogen content in exfoliated cells of oral mucosa as an adjunct in the diagnosis of diabetes mellitus. The smears were taken from buccal mucosa of 30 type 2 diabetes mellitus patients (study group) and 30 healthy individuals (control group). One smear was stained with rapid Papanicolaou stain and the other with periodic acid Schiff stain (PAS). In Papanicolaou stain smears, the nuclear area, cytoplasmic area and cytoplasmic to nuclear ratio were evaluated from 50 cells in each smear using Image analysis software (Q Win Standard, Leica™) and a research microscope (DM 2500, Leica). PAS-stained smears were analyzed for the presence of glycogen in exfoliated cells. The results showed that the mean nuclear area was significantly higher (p < 0.001) in the study group whereas the mean cytoplasmic area did not exhibit a statistically significant difference (p > 0.001). The mean cytoplasmic to nuclear ratio was significantly lower in the study group (p < 0.001). There was a significant increase in the count of PAS-positive exfoliated cells of the study group as compared with the control group (p < 0.001). The results associated with clinical observations suggest that type 2 diabetes mellitus can produce morphologic and functional alterations in oral epithelial cells, detectable by microscopic and cytomorphometric analysis using exfoliative cytology which can be used in the diagnosis of the disease.

OBJECTIVE: To compare exfoliative cytology from the oral mucosa of smokers and nonsmokers, with emphasis on proliferative activity. METHODS: Exfoliative cytology specimens were obtained from clinical normal mucosa from the lateral border of the tongue in 30 nonsmokers and 30 smokers ranging in age from 40 to 70 years of age, who were seen at the Heart Institute's Patient Center and the Smoking Cessation Program of the University Hospital, University of São Paulo Medical School (InCor-HCFMUSP). The cytologic specimens were evaluated by Papanicolaou staining and AgNOR quantification in order to evaluate the presence of cytological alterations suggestive of inflammation, dysplasia, keratinization, and proliferative activity of epithelial cells. RESULTS: Only Papanicolaou Class I and Class II smears were observed. Inflammatory alterations were found in 90% of smokers and in 87% of nonsmokers. The number of AgNORs/nucleus differed significantly between smokers and nonsmokers (3.372 +/- 0.375 versus 2.732 +/- 0.236). CONCLUSIONS: Within the limitations of this research, the results indicate higher proliferative activity in smoking patients compared to nonsmoking patients, even in the absence of clinical lesions.

The effect of glue snuffle on the expression of argyrophilic nucleolar organizer regions (AgNORs), an indicator of ribosome biosynthesis, in epithelial cells of oral mucosa has been investigated. AgNOR was evaluated by cytochemical staining in 148 Indian street boys (median age 12 year) who had different bad addictions like tobacco smoking, chewing and most importantly inhaling glue and 20 age- and body mass index-matched school boys who had no such type of bad habit. Compared with school boys, glue addicted street boys showed remarkably increased number of AgNOR dots per nucleus (9.38+/-1.84 vs. 3.12+/-0.87, p<0.001), AgNOR size (1.34+/-0.52 vs. 0.43+/-0.02mum(2), p<0.001) and percentage of AgNOR occupied nuclear area (9.38+/-2.12 vs. 0.99+/-0.03%, p<0.001). Increase in number and size of the dots is also higher in tobacco smokers and chewers when compared with school boys but a remarkable difference was recorded in glue addicted boys. The changes in AgNOR expression were positively associated with years of addiction after controlling potential confounders. Thus, glue snuffle appeared to be a risk factor for abnormal cell growth via up-regulation of ribosome biogenesis.

ABSTRACT : An evaluation of the cellular alterations in the smoker's oral mucosal cells was performed. Exfoliative Citology technique were applied and the cytologic smears stained with silver for quantitative analyses of Argyrophilic nucleolar organizer regions.(AgNORs). Cytologic smears were collected from two anatomic sites, mouth floor and tongue border with the purpose of relating the frequency of smoking with the quantitative analyses of the AgNORs. This study showed that the average number of AgNORs/nucleus is related with the number of cigarettes per day in the mouth floor of smoker's. These results suggest a possible relation between the number of cigarettes per day and an increase rate of cellular proliferation in the oral mucosal cells.

OBJECTIVE To compare the argyrophilic nucleolar organizer region (AgNOR) count of cells collected from the normal buccal mucosa of cigarette smokers, opium addicts and nonsmokers. STUDY DESIGN Exfoliative cytologic smears of buccal mucosa from 25 smokers, 25 addicts and 25 nonsmokers were stained for AgNORs according to the Ploton's method. The AgNOR count was performed on 100 cells. These AgNOR counts were compared and analyzed using the SPSS 13 program (SPSS, Inc., Chicago, Illinois, U.S.A.) and one-way ANOVA test. RESULTS Statistically, the highest mean AgNOR count (mAgNOR) was in cells from opium addicts (9.21 +/- 2.95) and the lowest in cells from nonsmokers (4.35 +/- 1.62)(p < 0.0001). For smokers, this value was in midrange (5.68 +/- 2.17). The percentage of cells with 6 or more AgNORs (pAgNOR > or =6) was the best discriminator among the different groups (p < 0.0001). CONCLUSION Cigarette smoking and particularly opium abuse increases the rate of cellular proliferation in cells of normal buccal mucosa.

BACKGROUND The number of argyrophilic nucleolar organizer regions (AgNOR) correlates with cellular proliferative activity. Comparing nonrecurrent, recurrent, atypical and malignant meningiomas we studied the value of the routine applicability of the AgNOR count in the prognostication of this tumor. PATIENTS AND METHODS Two hundred and thirty-eight meningiomas were reviewed blindly and graded using WHO grading schema. Eighty-one cases were selected and arranged in six groups according to clinical data and grading: 14 benign non-recurrent meningiomas; 14 primary benign recurrent meningiomas and their subsequent benign recurrences; 14 atypical; 11 malignant and 14 spinal meningiomas. Silver-stained slides were prepared and mean, median and standard deviation of AgNOR dots determined. RESULTS There was a proportionate increase of AgNOR dots with increasing tumor grade. There was a significant difference between benign non-recurrenttumors versus benign recurrent (P<0.0001) and atypical or malignant (P<0.0001) tumors. A difference was also noted between the recurring tumors versus malignant ones (P = 0.002) but no significant difference was seen between recurrent and atypical; atypical and malignant; intracranial and intraspinal; and primary of recurring meningiomas with their subsequent recurrences. A mean AgNOR count of <2.3 could separate benign tumors from atypical or malignant meningiomas with 93% specificity; and 93% of tumors with benign histology had no recurrence potential if their mean AgNOR count was less than 1.8. CONCLUSION This study indicates that in meningioma, the AgNOR count has a good correlation with tumor grading and recurrence, which may aid pathologists and clinicians in predicting tumor behavior.

BACKGROUND Argyrophilic nucleolar organizer regions (AgNORs) and MIB-1 as proliferating activities have been applied separately to assess the malignant potential of cancer cells. We conducted staining of AgNORs and MIB-1 in 42 surgically-resected invasive breast carcinomas. MATERIALS AND METHODS Paraffin-embedded sections were used for double staining and the mean AgNOR counts in 100 MIB-1-positive and -negative cells were calculated. RESULTS The mean AgNOR count in MIB-1-positive cells was significantly higher than in MIB-1-negative ones. AgNOR counts in MIB-1-positive tumors were significantly higher in tumors > or =2 cm and those with positive nodes. Multivariate analysis identified the AgNOR count in MIB-1-positive tumors as the only independent factor related to node metastasis. Survival of patients with lower counts of AgNORs in MIB-1-positive tumors was significantly better compared to those with higher counts. CONCLUSION Double staining of MIB-1 and AgNORs is useful for predicting lymph node metastasis and prognosis of patients with breast carcinoma.

OBJECTIVE To evaluate cell proliferative activity by counting and measuring argyrophilic nucleolar organizer regions (AgNORs) per nucleus in cell smears from mucosa clinically exposed to smoking and alcohol. STUDY DESIGN Group 1 (control) consisted 17 patients, group 2 (smoking) of 25 and group 3 (smoking and alcohol) of 18. Cell smears collected from the mucosa of the lower lip, border of the tongue and floor of the mouth underwent AgNOR staining. Mean number and mean area of AgNORs per nucleus were calculated for the first 50 cells in each smear. ANOVA and the Tukey test were used for statistical analyses at a 5% significance level. RESULTS Statistical analyses revealed a greater mean number and larger mean area of AgNORs per nucleus in groups 2 (smoking) and 3 (smoking and alcohol). Samples from the border of the tongue had the lowest mean values for number and area of AgNORs per nucleus in comparison with samples from the lower lip and floor of the mouth in the 3 groups. CONCLUSION Anatomic sites exposed to smoking or to smoking and alcohol had increased cellular proliferative activity.