Number of argyrophilic nucleolar organizer regions is a good indicator of lymph node metastasis in patients with esophageal carcinoma.

The number of argyrophilic nucleolar organizer regions (AgNORs) was evaluated as a predictor of lymph node metastasis in 45 patients who had undergone resection of advanced squamous cell carcinoma of the esophagus. The mean AgNOR score of carcinomas was 5.0 +/- 1.8, and it was greater than that of normal esophageal epithelium adjacent to a carcinoma (2.3 +/- 0.5, P < 0.001). The AgNOR score of tumors from 26 patients with lymph node metastasis was 6.1 +/- 1.6, and it was greater than that of tumors from 19 patients without lymph node metastasis (3.7 +/- 1.0, P < 0.001). The AgNOR scores of metastatic lymph nodes (4.9 +/- 1.5) from 26 patients with lymph node metastasis were closely related to the number of metastatic lymph nodes of individual patients (r = 0.582, P < 0.0001). The 3-year survival rate in patients with low AgNOR scores (AgNOR score < 5, n = 22) was 56.2%. By contrast, that in patients with high AgNOR scores (AgNOR score > or = 5, n = 20) was only 13.1%. There was a statistically significant difference between the two survival curves (P < 0.05). These results indicate that the AgNOR score is a good indicator of lymph node metastasis and suggest that it might also be a useful prognostic marker in patients with esophageal cancer.