Digital image analysis of silver-stained nucleolar organizer region- associated proteins in endometrial cytologic samples

Vesna Mahovlić, Silvana Audy-Jurković, Ana Ovanin-Rakić, Marijo Bilušić, Marin Veldić, Damir Babić, Jadranka Božikov, Žarko Danilović

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


OBJECTIVE: Digital image analysis was applied to determine the number, area and size of silver-stained nucleolar organizer regions (AgNORs) in cytologic samples from curettage in normal, hyperplastic and malignant endometrium. STUDY DESIGN: Thirty-two archival cytologic smears from curettage (previously stained by the Papanicolaou method) with the histologic diagnosis (4 inactive endometrium, 5 secretion, 5 proliferation, 5 simple hyperplasia, 5 complex hyperplasia, 3 atypical hyperplasia, 5 adenocarcinoma, grade 1) were analyzed with the AgNOR technique. Count, area and size of AgNORs were analyzed in 50 calls per sample using a magnification of 1,000 x. Quantitative analysis was performed on an SFORM digital imaging system. Data were analyzed with the SPSS/PC+ program. Mann-Whitney and χ2 tests were performed. RESULTS: The average value of AgNOR count increased from normal to hyperplastic endometrium and well-differentiated adenocarcinoma. Differences were significant except between atypical hyperplasia and adenocarcinoma. Four, five and more AgNORs in 40% or more of the nuclei were found in complex and atypical hyperplasia and adenocarcinoma. Proliferation, and simple and atypical hyperplasia had similar mean values of AgNOR area. The mean total AgNOR area value increased from normal to hyperplastic and well- differentiated adenocarcinoma. Differences were statistically significant. AgNOR size in well-differentiated adenocarcinoma was significantly different from that in normal endometrium and different grades of hyperplasia. CONCLUSION: Digital image analysis of AgNOR count, area and size enabled a distinction to be made between normal hyperplastic and malignant endometrium.

Original languageEnglish (US)
Pages (from-to)47-53
Number of pages7
JournalAnalytical and Quantitative Cytology and Histology
Issue number1
StatePublished - Feb 1 1999


  • Endometrium
  • Image analysis, computer-assisted
  • Nucleolus organizer region

ASJC Scopus subject areas

  • Anatomy
  • Histology


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