Proliferative activity in oral carcinomas studied with Ag-NOR and electron microscopy

This study was conducted on 61 patients (27 males and 34 females). The age ranged from 27 to 81 years (mean 54 years). All suffered from oral squamous cell carcinoma and were treated by surgery and deep X-ray therapy (DXT). The UICC and TNM classification and staging recommendations were used for evaluation of the patients. All sections were stained with Ag-NORs stain for examination of the proliferative activity of the squamous cell carcinomas. Biopsies were also taken from another 6 cases--3 cases with normal striated muscle and 3 cases from normal oral mucosa--and served as controls. Statistical studies of Ag-NOR scores were classified into 3 scores: the p values of score I (ANOVA test) were .0001, score II (ANOVA test) was .0001, and score III (ANOVA test) was 06. Both scores I and II were highly significant and score III was significant. Electron microscopy (EM) showed tumor cells with irregular shape and size and with remarkable division of nuclei and chromatin clumps emarginated toward nuclear membrane, and some cases showed chromatin condensed at one pole of the nucleus. Few mitochondria with dilated cristae (?) and abundant rough endoplasmic reticulum (RER) were observed. Few apoptotic changes were noted. This study showed a high proliferation in poorly differentiated squamous cell carcinomas. The amount of Ag-NOR in poorly differentiated squamous cell carcinomas was a prognostic factor and represented an unfavorable prognostic feature in squamous cell carcinoma of the oral mucosa.