Evaluation of proliferative activity of gnathic low-grade centrosteosarcoma: A report of 10 cases and review of literature

Abstract

Context: Low-grade central osteosarcoma (LCOS) is a clinically less aggressive form of osteosarcoma that may mimic benign fibrosseous lesions both clinically and histopathologically. The lesion also shows bland cytologic features, which makes it difficult to diagnose. Irrespective of its histologic features, it has the potential to metastasise, therefore posing a significant mortality risk to the patient.

Objective: The objective of the study was to highlight the proliferation index of low-grade central osteosarcoma using histochemical and immunohistochemical methods, using argyrophilic nucleolar organizer region (AgNOR) staining and MiB-1, respectively. In addition, the study aimed to assess the correlation of the histochemical and immunohistochemical methods.

Materials And Methods: The study was a cross-sectional study in which histologically diagnosed cases of low-grade central osteosarcoma seen over the last 30 years at the Lagos University Teaching Hospital were retrieved and analysed for their proliferative index using AgNOR staining and MiB-1 immunohistochemical staining.

Result: A total of 10 cases that met the selection criteria were retrieved. The mean PAgNOR of LCOS was 14% +/-4.97 while the PMiB-1 was 9.55% +/-4.49. Test of correlation between PAgNOR and PMiB-1 of LCOS showed a positive correlation (r =0.70).

Conclusion: The study showed that although histologically, LCOS may appear bland, they have significant levels of proliferative activity. The significant positive correlation of AgNOR staining and MiB-1 showed that when there are logistical challenges to the use of immunohistochemistry, special stains can be used to assess the proliferative activity of lesions, especially in resource-deprived settings.