Argyrophilic nucleolar organizer regions staining is useful in predicting recurrence-free interval in oral tongue and floor of mouth squamous cell carcinoma

Background Argyrophilic nucleolar organizer regions (AgNORs) represent a tissue marker of cell proliferative activity. The purpose of this study was to assess the prognostic value of AgNORs expression in oral squamous cell carcinoma (SCC). Methods The AgNORs area/nucleus was studied in paraffin sections by means of digital image analysis in 43 cases of stage II oral tongue and floor of the mouth SCC. Results Time free of disease was considered a dependent variable of a binary indicator of Ag-NORs expression (7.77 μm2/nucleus as a cut-off point). High AgNORs level was associated with a statistically significant negative effect on recurrence-free interval of disease in a Cox proportional hazards models controlled for occult lymph node metastasis, involvement of the surgical margins, thickness of the lesion, and vascular invasion. Conclusions The AgNORs area increased the capability of predicting which patients have a high risk of recurrence of cancer, and its evaluation may provide useful information for the therapeutic approach to the oral tongue and floor of the mouth SCC.