AgNOR pattern and PCNA analysis in fine needle biopsies of liver cell carcinoma

The aim of this study was to evaluate the prognostic and diagnostic value of AgNOR and PCNA staining mainly in fine needle biopsies of 34 liver cell carcinomas using an image analyzing system. The AgNOR number per nucleus and the relative AgNOR area, but not the PCNA index, showed a significant correlation with the histological tumor grade according to the classical and the modified Edmondson-Steiner's classification. Regarding univariate survival, only the grade of the classical Edmondson-Steiner's classification was of prognostic significance. The parameters sex, age, maximum tumor diameter, mean AgNOR number, total nuclear area and relative AgNOR area, nuclear area, PCNA index or the grade of the modified Edmondson-Steiner's classification did not reach statistical significance regarding survival. By a factor analysis, two factors could be created, which could explain together 72% of the variance of all parameters included in the study. In a linear discriminant analysis, the AgNOR variables could separate between normal liver cells and cells from high grade or low grade carcinomas in 83.7% of the cases. Therefore, we think that the AgNOR technique can be usefully applied in needle biopsies of liver carcinomas for the differential diagnosis and tumor grading.