Gallbladder carcinoma is rare but is a highly
lethal neoplasm. The present study evaluates the expression of AgNOR
parameters, morphometry and Ki67 index by IHC in neoplastic gall bladder
lesions according to histological grade. Tissue sections from 50 cases of
gallbladder disease, including 25 cases of gallbladder carcinoma and 25 cases
of chronic cholecystitis were studied. On morphometry, mean nuclear area and
N/C ratio of Neoplastic group was significantly higher as compared to that of
Non-neoplastic group. Ki-67 expression was studied in neoplastic cases only
where it ranged from 15 to 40%. Mean Ki67 expression was 28.20?7.83%. AgNOR
count ranged from 1 to 14. In neoplastic cases mean AgNOR count was 7.88?2.42
as compared to 2.32?1.07 in non-neoplastic cases, thus showing a significant
difference between two groups. On receiver operator curve analysis, a cut-off
value of Nuclear area >86 was observed to be 96% sensitive and 84% specific
in detection of neoplastic cases. A cut-off value >0.433 for N/C ratio was
observed to be 100% sensitive and 84% specific in diagnosis of non-neoplastic
condition. An AgNOR cut-off value >5%, was 100% sensitive and 100% specific
in discriminating between neoplastic and non-neoplastic lesions. In neoplastic
group, N/C ratio, AgNOR & Ki-67 expression did not show a significant
association with histopathological type but showed a significant association
with histopathological grade. On the basis of above evaluation, it can be
concluded that AgNOR count, Ki67 and cytomorphometric parameters i.e. N/C ratio
show a high discriminant value in discrimination between neoplastic and
non-neoplastic lesions. These markers also showed a significant association
with the histopathological grade, however, owing to fewer numbers of cases, the
association between histopathological type and these markers remains
unsubstantiated. - See more at:
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