The Paris System for reporting urinary cytology improves the negative predictive value of high-grade urothelial carcinoma.
High-grade urothelial carcinoma
Negative predictive value
The Paris System for reporting urinary cytology
Urine cytology
Urothelial carcinoma
Journal
BMC urology
ISSN: 1471-2490
Titre abrégé: BMC Urol
Pays: England
ID NLM: 100968571
Informations de publication
Date de publication:
05 Apr 2022
05 Apr 2022
Historique:
received:
06
01
2022
accepted:
29
03
2022
entrez:
6
4
2022
pubmed:
7
4
2022
medline:
8
4
2022
Statut:
epublish
Résumé
The Paris System (TPS) for reporting urinary cytology differs from conventional systems (CS) in that it focuses on the diagnosis of high-grade urothelial carcinoma (HGUC). This study investigated the impact of TPS implementation on the diagnostic accuracy of HGUC by comparing it with our institutional CS. A total of 649 patients who underwent transurethral resection of bladder tumor (TURBT) between January 2009 and December 2020 were included in this study. Our institution adopted TPS to report urinary cytology in February 2020. The diagnostic accuracy of HGUC in preoperative urinary cytology was compared with the presence or absence of HGUC in resected specimens of TURBT before and after TPS implementation. After implementing TPS in urinary cytology, 89 patients were reviewed and compared with 560 patients whose urinary cytology was diagnosed by CS. TPS and CS for detecting HGUC had 56.0% and 58.2% sensitivity, 97.8% and 91.2% specificity, and 93.3% and 87.9% positive predictive values, respectively. There were no significant differences between TPS and CS in terms of sensitivity, specificity, and positive predictive value for HGUC (P = 0.83, 0.21, 1.00). On the other hand, the negative predictive value for HGUC using TPS was 80.0%, which was significantly higher than that of CS (66.4%, P = 0.04) The multivariate logistic regression analysis indicated that not using TPS was one of the independent predictive factors associated with false-negative results for HGUC (odds ratio, 2.26; 95% confidence interval, 1.08-4.77; P = 0.03). In instances where urinary cytology is reported as negative for HGUC by TPS, there is a low probability of HGUC, indicating that TPS has a potential diagnostic benefit.
Sections du résumé
BACKGROUND
BACKGROUND
The Paris System (TPS) for reporting urinary cytology differs from conventional systems (CS) in that it focuses on the diagnosis of high-grade urothelial carcinoma (HGUC). This study investigated the impact of TPS implementation on the diagnostic accuracy of HGUC by comparing it with our institutional CS.
METHODS
METHODS
A total of 649 patients who underwent transurethral resection of bladder tumor (TURBT) between January 2009 and December 2020 were included in this study. Our institution adopted TPS to report urinary cytology in February 2020. The diagnostic accuracy of HGUC in preoperative urinary cytology was compared with the presence or absence of HGUC in resected specimens of TURBT before and after TPS implementation.
RESULTS
RESULTS
After implementing TPS in urinary cytology, 89 patients were reviewed and compared with 560 patients whose urinary cytology was diagnosed by CS. TPS and CS for detecting HGUC had 56.0% and 58.2% sensitivity, 97.8% and 91.2% specificity, and 93.3% and 87.9% positive predictive values, respectively. There were no significant differences between TPS and CS in terms of sensitivity, specificity, and positive predictive value for HGUC (P = 0.83, 0.21, 1.00). On the other hand, the negative predictive value for HGUC using TPS was 80.0%, which was significantly higher than that of CS (66.4%, P = 0.04) The multivariate logistic regression analysis indicated that not using TPS was one of the independent predictive factors associated with false-negative results for HGUC (odds ratio, 2.26; 95% confidence interval, 1.08-4.77; P = 0.03).
CONCLUSION
CONCLUSIONS
In instances where urinary cytology is reported as negative for HGUC by TPS, there is a low probability of HGUC, indicating that TPS has a potential diagnostic benefit.
Identifiants
pubmed: 35382830
doi: 10.1186/s12894-022-01005-8
pii: 10.1186/s12894-022-01005-8
pmc: PMC8985280
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
51Informations de copyright
© 2022. The Author(s).
Références
Cancer Nurs. 2019 May/Jun;42(3):E21-E33
pubmed: 29863576
Lancet. 2016 Dec 3;388(10061):2796-2810
pubmed: 27345655
Cytopathology. 2020 Jan;31(1):35-40
pubmed: 31596979
J Infect Dis. 1973 Jan;127(1):49-55
pubmed: 4683102
Cancer Cytopathol. 2016 Mar;124(3):174-80
pubmed: 26524350
Urol Clin North Am. 2000 Feb;27(1):25-37
pubmed: 10696242
Eur Urol. 2022 Jan;81(1):75-94
pubmed: 34511303
J Clin Endocrinol Metab. 2013 Apr;98(4):1450-7
pubmed: 23436916
J Am Soc Cytopathol. 2021 Jan-Feb;10(1):14-19
pubmed: 33221245
J Cytol. 2019 Jul-Sep;36(3):169-173
pubmed: 31359918
Cancer Cytopathol. 2017 Jun;125(6):427-434
pubmed: 28272842
Pathol Int. 2010 Jan;60(1):1-8
pubmed: 20055945
Cytopathology. 2016 Jun;27(3):153-6
pubmed: 27221750
Cancer Cytopathol. 2018 Jun;126(6):430-436
pubmed: 29663682
CA Cancer J Clin. 2021 May;71(3):209-249
pubmed: 33538338
Nat Rev Cancer. 2015 Jan;15(1):25-41
pubmed: 25533674
Diagn Cytopathol. 2016 Dec;44(12):994-999
pubmed: 27781412