University Publications

Background: Oral squamous cell carcinoma (OSCC) is a major global health issue, particularly in regions with high tobacco and alcohol use, and accounts for 95% of oral cancers. The AgNOR staining technique, which identifies nucleolar organizer regions (NORs) associated with ribosome production, is used to assess cellular proliferation. Objective: This study aims to explore the potential of AgNOR quantification as a prognostic tool for OSCC. Materials and Methods: This retrospective study analyzed 44 cases of oral squamous cell carcinoma (OSCC) from Khartoum Dental Hospital, classifying them into well-differentiated, moderately differentiated, and poorly differentiated based on cytological diagnosis. AgNOR staining was performed, and the percentage of AgNOR-positive cells was recorded. Nucleolar organizer regions (NORs) were counted using a ×100 oil immersion lens, with ten fields randomly selected for analysis and areas with necrosis or artifacts excluded. Statistical analysis was conducted using SPSS version 21, presenting results as percentages and frequencies. Ethical approval was obtained from Al-Neelain University, and informed consent was provided by all participants, although the ethical approval number was lost due to the recent conflict in Sudan. Results: The study involved 44 patients diagnosed with oral squamous cell carcinoma (OSCC), consisting of 30 males (68.2%) and 14 females (31.8%), with a mean age of 53.5 years. Cytological samples were collected from various tumor sites, including the floor of the mouth, tongue, lower lip, palate, and lower jaw. Tumors were classified as well-differentiated (50%), moderately differentiated (31.8%), and poorly differentiated (18.2%). AgNOR percentages varied across the samples, ranging from 25% to 97%, with a mean of 65%. Well-differentiated OSCC exhibited AgNOR dot percentages from 25% to 95%, moderately differentiated OSCC ranged from 43% to 97%, and poorly differentiated OSCC showed percentages from 35% to 87%. Conclusion: Well-differentiated OSCC showed the lowest AgNOR expression, reflecting lower proliferative activity, while moderately differentiated OSCC exhibited higher AgNOR counts, indicating increased proliferation. Poorly differentiated OSCC had variable AgNOR expression, possibly due to genetic instability. Although AgNOR count did not correlate significantly with prognosis, it may serve as a useful prognostic tool, particularly when histopathological differentiation alone is insufficient. The study highlights the need for larger cohorts and additional markers to confirm these findings and further explore AgNOR’s role in OSCC progression.