[Image analysis of AgNORs in esophageal balloon cytosmears]

A computer-assisted microimage analysis system and silver staining techniques were applied to quantitate the amount of the argyrophilic proteins associated with the nucleolar organizer regions (AgNORs) in nuclei of esophageal balloon cytosmears derived from 105 cases with esophageal squamous normal, hyperplasia, marked dysplasia grade I and grade II, near-carcinoma and carcinoma. The results showed that the averages of silver stained area and number of AgNORs per nucleus, mean area per AgNOR, and the mean number of bigger AgNORs per nucleus in different grade cells were increased with the increasing in cell grade (P < 0.01); the ratio of AgNORs area to nucleus area per cell was increased and the form factor of AgNORs was decreased in cancer cells (P < 0.01); there only were 1-3 AgNORs in a few dysplasia and cancer cells, but the AgNORs area per nucleus of them were increased with the increasing in cell grade (P < 0.01); 95% of predicted cells were correctly identified (reclassification) in cancer and noncancer cells. The results suggest that the current classification of esophageal cytology is rational and reliable, indicating different level of cell proliferation in different grade cells. The AgNORs area is a more sensitive, accurate and reliable parameter indicating cell proliferation than the AgNORs number does.