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Published on: January 17, 2018
Application of the International System for Reporting Serous Fluid Cytology (ISRSFC) and AgNOR Staining for Improved
Magdi M Salih1, Shatha A Alotaibi2, Adil A M Yousif3
1Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia M.salih@tu.edu.sa.
Objective:
Serous effusion smears categorized as suspicious for malignancy (SFM) pose significant diagnostic challenges. This study aimed to evaluate the diagnostic utility of argyrophilic nucleolar organizer region (AgNOR) quantification across International System for Reporting Serous Fluid Cytology (ISRS-FC) categories and to assess its association with increasing cytological atypia and malignancy risk.
Methods:
A total of 160 serous effusion samples collected between October 2024 and June 2025 were examined using Papanicolaou and AgNOR staining. Cases were classified into negative for malignancy (NFM), atypia of undetermined significance (AUS), suspicious for malignancy (SFM), and malignant (MAL). Mean Ag-NOR counts were compared across categories using appropriate statistical analyses.
Results:
Mean Ag-NOR counts (mean±SD) increased progressively from NFM (5.64±4.45) and AUS (5.98±5.15) to SFM (7.66±6.62) and MAL (8.64±7.81). One-way ANOVA demonstrated a significant difference among groups (p=0.001). Post hoc analysis confirmed significantly higher counts in SFM and MAL compared with NFM, and in MAL compared with AUS (p<0.05).
Conclusion:
AgNOR quantification provides objective proliferative information that may enhance diagnostic stratification in serous effusion cytology, particularly in indeterminate categories. Further multicenter studies are required to establish standardized cut-off values before routine clinical application.
