Are we on track for diagnosing high‐grade urothelial carcinoma with a minimum quantity of five malignant cells in lower tract specimens? Critical analysis of The Paris System Quantitation Criteria

Folarin, Olawunmi S.; Siddiqui, Momin T.

doi:10.1002/cncy.22749

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…The second cohort was considered “positive” despite a negative histology. Thus, the study established the robustness of the current TPS numeric criteria of a minimum of five HGCs for detecting HGUC 53 …”

Section: Discussionmentioning

confidence: 99%

A comparison between conventional and the Paris systems of reporting urinary cytopathology with a literature update

Kannan,

Gochhait,

Ramanitharan

et al. 2024

Diagnostic Cytopathology

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IntroductionOwing to certain inherent limitations of earlier reporting systems, “The Paris System for Reporting Urinary Cytology (TPS)” was implemented in 2015 to standardize reporting urine cytology with more stringent cytomorphologic criteria. We share our post‐TPS experience, comparing it with the conventional system (CS).AimTo assess and compare the cyto‐histopathologic/cystoscopic agreement between the conventional and the Paris systems (CS and TPS) for reporting urine cytology.Materials and MethodsIt is a cross‐sectional study involving urine samples from 170 patients divided into two groups (CS and TPS). Of the 170 cases, 85 were reported according to the CS, and 85 were reported according to TPS with all the relevant clinical, radiologic, and cystoscopic findings. Using the kappa statistics, both groups were statistically analyzed for sensitivity, specificity, predictive values, and agreement.ResultsThe sensitivity and specificity for high‐grade urothelial carcinoma (HGUC) as per TPS were 83.33% and 94.59%, respectively, while they were 73.47% and 80.56% for the conventional system. The agreement for HGUC with TPS was 87.06% with a kappa value of 0.7416, while it was 76.5% with a kappa value of 0.53 for the CS. Implementing the TPS minimized usage of the atypical urothelial cells (AUC) category, increasing the clarity in detecting HGUC.ConclusionTPS provides better agreement with histopathology than the CS for diagnosing HGUC, which is attributable to stringent TPS criteria that prompt cytopathologists to look more diligently for morphologic and numeric criteria.

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Section: Discussionmentioning

confidence: 99%

A comparison between conventional and the Paris systems of reporting urinary cytopathology with a literature update

Kannan,

Gochhait,

Ramanitharan

et al. 2024

Diagnostic Cytopathology

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Utility of The Paris System for Reporting Urinary Cytology in patients with HPV‐positive urinary tract carcinoma

Tanaka,

Kayraklioglu,

Chan

et al. 2024

Cancer Cytopathology

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BackgroundHuman papillomavirus (HPV)‐positive urinary tract carcinomas (UTCas) have distinct morphology and molecular features with potential treatment implications. Cytomorphologic analysis of these tumors on urine cytology specimens has not yet been reported. The authors evaluated the cytomorphologic findings of HPV‐positive UTCa on urine cytology using The Paris System for Reporting Urinary Cytology (TPS) criteria.MethodsHPV‐positive cases were identified by a retrospective review of surgical specimens that had UTCa confirmed by HPV in situ hybridization. Cases that had concurrent urine cytology were reviewed using TPS. Cytomorphologic features of high‐grade urothelial carcinoma (HGUC) were evaluated as well as the presence of atypical squamous cells (ASCs) and basaloid features.ResultsSixteen cytology specimens from eight patients with HPV‐positive UTCa were included. On original diagnosis, none of the cytology specimens were suggested to be HPV‐associated. TPS diagnostic criteria identified eight cases with at least atypical findings, including five HGUC cases, one case that was suspicious for HGUC, and two atypical urothelial cases. Common cytomorphologic features included basaloid clusters (six of eight cases; 75%) and ASCs (four of eight cases; 50%) that matched the corresponding surgical specimens. Most cases exhibited urothelial cell hyperchromasia (seven of eight cases; 88%), and hypochromasia was a frequently observed variant (four of eight cases; 50%), either alone or in addition to hyperchromasia.ConclusionsHPV‐positive UTCa can be identified reliably as HGUC by using TPS criteria; however, these cases may not be recognized as HPV‐associated. The presence of basaloid cells or ASCs can help suggest screening for HPV in urine specimens. Larger scale studies are warranted to validate cytomorphologic differences and determine the impact of HPV infection on clinical outcomes for patients with UTCa.

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Are we on track for diagnosing high‐grade urothelial carcinoma with a minimum quantity of five malignant cells in lower tract specimens? Critical analysis of The Paris System Quantitation Criteria

Cited by 2 publications

References 28 publications

A comparison between conventional and the Paris systems of reporting urinary cytopathology with a literature update

A comparison between conventional and the Paris systems of reporting urinary cytopathology with a literature update

Utility of The Paris System for Reporting Urinary Cytology in patients with HPV‐positive urinary tract carcinoma

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