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TITLE:

IMPORTANCE OF AGNOR STAINING IN AMEOBLASTOMA HISTOLOGICAL GRADING

AUTHORS:

Dr Yusra Nayab Khan, Dr Sana Tariq, Dr Ayesha Bashir

ABSTRACT:

Objective: To compare different histological variants of ameloblastoma in terms of proliferative activity, to use histochemical methods of AgNORs and to classify different types of ameloblastomas. Place and Duration: In the Department of Pathology of Services Hospital Lahore for two year duration from January 2017 to December 2018. Methods: A cross-sectional study of 50 surgical specimens collected using a non-probability sampling technique of ameloblastoma was selected. All ameloblastoma variants (histological variants) were collected from all ages and sexes. The decay and unfixed tissues were removed from the study and all cases were determined by the presence of bone. All selected samples were fixed in 10% neutral formalin and treated with hematoxylin and eosin at the Pathology Department for initial selection. These sections were initially reviewed by two pathologists by examining several hematoxylin and eosin-stained tumor slides (mean, 2.5 slides per tumor, range, 2-8), and were diagnosed with consensus. Results: The mean age of the patients was 39.9 ± 15.1 between 12 and 80 years. There were 37 (76%) males and 13 (25%) females in this study. When AgNOR's mean values were examined in 4 study groups, the mean value of AgNOR was higher for acanthomatous, ie 3.15 ± 0.30 and the follicular variant was lower for 1.39 ± 0.82. Comparison of MAgNOR was performed using ANOVA and mean mAgNOR was different in 4 groups and p value was calculated as <0.001. In the histological variants, the association of mAgNOR 3.0 value was observed when the association of threshold value was observed (p = 0.003). Patients with MAgNOR> 3.0 were only in the desmoplastic and acanthomatous groups. Similarly, the relationship of pAgNOR> 5.0 was significant with histological variants (P <0.001). All desmoplastic and acanthomatous cases had pAgNOR> 5.0. The size relationship was significant with histological variables (p = 0.001). When the desmoplastic variants were in the dimensions of +1 and +2, acanthomatous was only +2. There were very few follicular cases in the +1 dimension. Similar results were found for the dispersion to be p <0.001 with histological variables. Conclusion: AgNOR staining technique may be useful in histopathological classification of ameloblastoma. The quantitative and qualitative evaluation of silver nitrate staining reflects a more malignant potential in acanthomatous and desmoplastic variants than in follicular and plexiform varieties. Key words: AgNOR, ameloblastoma, histological classification.

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