AgNOR Count and its Correlation with Colposcopy in Suspicious Cervix

To evaluate the correlation of AgNOR count and colposcopy in cases of suspicious cervix.

A hundred women presenting in OPD with complaints of postcoital bleeding, discharge per vaginum, pain in the lower abdomen, or intermenstrual bleeding were subjected to colposcopy. After colposcopy, a cervical biopsy was done. Routine paraffin sectioning was done for these biopsy specimens. Histopathologic diagnosis was first established on these sections using the routine (H & E) stain. Then, further sections were cut from prepared blocks and were subjected to AgNOR staining technique. AgNOR count was taken as the mean number of black dots per 100 cells observed under a 100× oil immersion objective.

In our study, 60 % cases were colposcopy positive and 40 % were colposcopy negative. The sensitivity of colposcopy in diagnosing all grades of dysplasias was 95.4 % and the specificity was 67.86 % in our study. The positive predictive value was 70 % and the negative predictive value was 95 %. The mean AgNOR score in our study was 1.21 ± 0.51 in chronic cervicitis, 2.44 ± 0.56 in mild dysplasia, 3.48 ± 0.35 in moderate dysplasia, and 4.58 ± 0.43 and 5.91 ± 0.51 in squamous cell carcinoma, showing a progressive increase in the score. AgNOR count showed an increase from CIN to SCC in our study. The correlation coefficient between the colposcopy and AgNOR count found in our study is 0.892 and p value is <0.0001 which is highly significant.

The results of the colposcopy and AgNOR when used together can provide strength to the clinician and histopathologist in diagnosing early carcinoma in cases of suspicious cervix.