Practical application of the Paris system for reporting urinary cytology
10.3760/cma.j.cn112151-20231012-00251
- VernacularTitle:尿细胞学巴黎报告系统的应用实践
- Author:
Lan CHEN
1
;
Longteng LIU
;
Mingjun SUN
;
Shurong HE
;
Dongge LIU
Author Information
1. 北京医院病理科 国家老年医学中心 中国医学科学院老年医学研究院，北京 100730
- Keywords:
Validation studies;
Urine;
Cytodiagnosis;
Paris system for reporting urinary cytology;
Risk of malignancy;
Risk of high-grade malignancy
- From:
Chinese Journal of Pathology
2024;53(5):470-476
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To validate the diagnostic performance of the Paris system for reporting urinary cytology (TPS).Methods:A total of 7 046 urine cytology samples from 3 402 patients collected in the Department of Pathology, Beijing Hospital, China from January 2020 to January 2022 were analyzed. 488 patients had a biopsy or resection specimen during the follow-up period of 6 months. The sensitivity, specificity, risk of malignancy (ROM) and risk of high-grade malignancy (ROHM) of the TPS were evaluated using histological diagnosis as the golden standard.Results:Among the 7 046 samples, high-grade urothelial carcinoma (HGUC) accounted for 5.7% (399/7 046), suspicious for high-grade urothelial carcinoma (SHGUC) for 3.2% (227/7 046), atypical urothelial cells (AUC) for 8.4% (593/7 046), and negative for high-grade urothelial carcinoma (NHGUC) for 72.9% (5 139/7 046) including low-grade urothelial neoplasm (LGUN) for 0.8% (59/7 046) and insufficient samples for 9.8% (688/7 046). 488 patients had a bladder biopsy or resection in the follow-up of six months, including 314 males and 174 females, aged 27 to 92 years (average, 66 years). The ROHM of TPS was 94.7% in HGUC, 83.3% in SHGUC, 41.3% in AUC and 18.8% in NHGUC. The sensitivity and specificity of urine cytology were 70.1% (169/241) and 97.0% (162/167), respectively. The negative predictive value of NHGUC was 69.2% (162/234).Conclusions:The study has shown that TPS classification has high sensitivity and specificity, high ROHM for HGUC and SHGUC, and high negative predictive value for NHGUC. The application of TPS reporting system can better interpret the clinical significance of cytology samples, improve the accuracy of urine cytopathology and ensure continuous diagnostic consistency.
