A qualitative and quantitative analysis of AgNORs in keratocystic odontogenic tumor, unicystic ameloblastoma and multicystic ameloblastoma

A comparative evaluation of proliferation activity in unicystic ameloblastoma (UA), multicystic ameloblastoma (MA) and keratocystic odontogenic tumor (KCOT) using silver staining technique. In the present study 21 histopathologically confirmed paraffin blocks,7 each of UA, MA and KCOT were selected and stained with silver nitrate. For quantitative analysis, 100 cells were counted at 1000x magnification for AgNORs and the mean value was calculated. Qualitative analysis of AgNORs included normal (oval shaped) and abnormal groups (bean shaped) in the lesion. The statistical analysis of data was done by a specialist statistician using two way ANOVA and multiple comparisons with Tukey's test in advanced excel. The AgNOR count was more in KCOT when compared to MA and UA with the pattern of distribution of AgNORs more in basal than in the parabasal layer in KCOT. The qualitative analysis showed small to large oval AgNOR's in KCOT and few clusters in MA whereas in UA irregular clusters were seen. This concludes the expediency of AgNOR staining in reflecting the high proliferation rate and a more aggressive behavior of KCOT in comparison to MA and UA which signifies requirement of a more hostile surgical approach in KCOT to avoid recurrences following different treatment modalities.