{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:33:29Z","timestamp":1762432409371,"version":"3.40.5"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Malignancy in pleural effusion is an indication of poor prognosis. The distinction between malignant cells and reactive mesothelial cells in effusion cytology is sometimes difficult and requires ancillary techniques. Evaluation of morphological indicators of chromosomal instability (CI) like micronuclei (MN), chromatin bridging (CB), nuclear budding (NB), and multipolar mitosis (MM) on routine cytology smears is a promising tool to distinguish malignant from benign ascitic fluids. However, it has been scarcely evaluated in pleural effusions. The present study was conducted to evaluate the diagnostic value of these markers in differentiating between malignant and benign pleural fluids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>It is a cross sectional study in which a total of 72 pleural fluid samples over a period of 2\u2009years received in the cytology department of the hospital were evaluated. The cytological analysis was done by two independent cytopathologists and interpreted as either malignant or benign. Four morphological markers of CI were counted in the May\u2010Gr\u00fcnwald Giemsa (MGG) stained smears of all the cases and the score was compared with the conventional cyto\u2010morphological diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 72 cases, there were 42 malignant and 30 benign effusions on cytological examination. The mean score of micronuclei count, nuclear budding, chromatin bridging and multipolar mitosis in malignant effusions were 7.26\u2009\u00b1\u20092.74, 9.55\u2009\u00b1\u20095.53, 1.83\u2009\u00b1\u20091.17, and 2.21\u2009\u00b1\u20091.62 respectively that was significantly higher than the benign effusions (1\u2009\u00b1\u20090.71, 1.1\u2009\u00b1\u20090.86, 0.38\u2009\u00b1\u20090.50, and 0.15\u2009\u00b1\u20090.37 respectively) (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). On Receiver operating characteristic (ROC) curve analysis, a cut\u2010off of 5 for the MN count had a sensitivity of 88% and specificity of 100% in detecting malignant pleural effusion [Area under curve (AUC) 95.8%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Evaluation of morphological indicators of CI on routine MGG stained smears is a simple and cost\u2010effective method to differentiate between benign and malignant pleural fluids.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dc.25249","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T07:37:00Z","timestamp":1699601820000},"page":"76-81","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Morphological markers of chromosomal instability as predictors of malignancy in pleural effusion"],"prefix":"10.1002","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5982-6425","authenticated-orcid":false,"given":"Phiza","family":"Aggarwal","sequence":"first","affiliation":[{"name":"Department of Pathology Government Medical College and Hospital  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1272-6955","authenticated-orcid":false,"given":"Uma","family":"Handa","sequence":"additional","affiliation":[{"name":"Department of Pathology Government Medical College and Hospital  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranjeev","family":"Bhagat","sequence":"additional","affiliation":[{"name":"Department of Pathology Government Medical College and Hospital  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Critical Care &amp; Sleep Medicine Government Medical College and Hospital  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24278"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.path.2018.05.003"},{"issue":"2","key":"e_1_2_10_4_1","first-page":"2019","article-title":"Anti\u2010EpCAM antibodies for detection of metastatic carcinoma in effusions and peritoneal wash","volume":"18","author":"Carneiro FP","year":"2019","journal-title":"Oncol Lett"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.13991"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.07.79"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9371.101167"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23249"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-06-2705"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-06-0326"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1383-5742(99)00053-8"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000320792"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9371.93208"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.12096"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.6835"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.4103\/JCRP.JCRP_3_22"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.21168"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/JOC.JOC_178_16"},{"issue":"2","key":"e_1_2_10_19_1","first-page":"354","article-title":"Increased micronucleus count predicts malignant behavior in pleural effusion fluid","volume":"48","author":"K\u00f6kenek \u00dcnal TD","year":"2018","journal-title":"Turk J Med Sci"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/JOC.JOC_42_19"}],"container-title":["Diagnostic Cytopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dc.25249","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T05:19:10Z","timestamp":1705900750000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/dc.25249"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,9]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/dc.25249"],"URL":"https:\/\/doi.org\/10.1002\/dc.25249","archive":["Portico"],"relation":{},"ISSN":["8755-1039","1097-0339"],"issn-type":[{"type":"print","value":"8755-1039"},{"type":"electronic","value":"1097-0339"}],"subject":[],"published":{"date-parts":[[2023,11,9]]},"assertion":[{"value":"2023-07-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}