Diagnostic terminology for urinary cytology reports including the new subcategories ‘atypical urothelial cells of undetermined significance’ (<scp>AUC</scp>‐<scp>US</scp>) and ‘cannot exclude high grade’ (<scp>AUC</scp>‐<scp>H</scp>)

Piaton, Éric; Decaussin‐Petrucci, Myriam; Mège‐Lechevallier, Florence; Advenier, Anne‐Sophie; Devonec, M.; Ruffion, A.

doi:10.1111/cyt.12050

Cited by 79 publications

(98 citation statements)

References 34 publications

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“…Over the decades, several classification schemes for reporting urine cytology have been proposed [10][11][12]. A single standard and widely accepted reporting system has not emerged.…”

Section: Resultsmentioning

confidence: 99%

Utility of the Paris System in Reporting Urine Cytology

et al. 2017

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Objective: To find out the utility of The Paris System (TPS) in reporting urine cytology and to compare it with the reporting system currently used in our laboratory. Study Design: This retrospective study was undertaken over a period of 1 year during which slides of all the urine specimens sent for cytological examination were retrieved from our laboratory filling system. They were blindly reviewed and reclassified according to TPS. Surgical follow-up was obtained from the uropathology services of our department. Results: A total of 176 cases were meticulously reviewed. The mean age of the patients was 52 years, and 71% of cases presented with hematuria. Histopathological follow-up was available in 34 cases. Reporting by TPS detected 13.0% high-grade urothelial carcinoma (HGUC) and 5.1% atypical urothelial cells versus 7.3 and 11.9% by the current reporting system, respectively. The sensitivity and diagnostic accuracy for detecting HGUC of TPS were higher than those of our reporting system. Conclusion: TPS has increased the rate of detection of HGUC and reduced the rate of reporting “atypical” urothelial cells. TPS has also standardized the diagnostic criteria, thereby bringing uniformity and reproducibility into the system of reporting for urine cytology.

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“…Over the decades, several classification schemes for reporting urine cytology have been proposed [10][11][12]. A single standard and widely accepted reporting system has not emerged.…”

Section: Resultsmentioning

confidence: 99%

Utility of the Paris System in Reporting Urine Cytology

et al. 2017

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“…The morphological criteria for the TPS diagnosis of atypia have been used in varied ways by many authors [1,4,6] , obtaining different rates of atypia. There are some authors that use subcategories of atypia [4,[6][7][8] .…”

Section: Discussionmentioning

confidence: 99%

“…There are some authors that use subcategories of atypia [4,[6][7][8] . However, Bostwick and Hossain [5] , in a very comprehensive study, found no use in stratifying urothelial cell atypia for diagnostic accuracy.…”

Section: Discussionmentioning

confidence: 99%

Applying the Paris System for Reporting Urine Cytology Increases the Rate of Atypical Urothelial Cells in Benign Cases: A Need for Patient Management Recommendations

et al. 2016

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The Paris System (TPS) for reporting urinary cytology attempts to unify the terminology in this field. Objectives: To analyze the impact of adopting TPS by measuring nomenclature agreement and cytohistological correlation. Materials and Methods: Voided urine liquid-based cytology samples corresponding to 149 biopsy-proven cases (76 high-grade carcinomas, 40 low-grade carcinomas, and 33 benign lesions), were reclassified by the same pathologist using TPS. Diagnostic agreement and sensitivity for both nomenclature systems was measured. Results: When using TPS, the rate of atypical samples increased 8 times (from 3 to 24.2%) in benign cases, 10 times (from 2.5 to 25%) in low-grade carcinomas, and 2.4 times (from 6.6 to 15.8%) in high-grade carcinomas. The false-positive rate (abnormal cytology in negative or low-grade carcinoma cases) increased from 11 to 34.2%. Sensitivity was higher (63 vs. 49%) with TPS at the expense of a lower specificity (73 vs. 91%). The agreement between both nomenclatures was moderate for negative and high-grade carcinoma cases (k = 0.42 and 0.56, respectively) and weak for low-grade tumors (k = 0.35). Conclusions: Adopting TPS for reporting urine cytology results in a considerable increase in atypical diagnoses, improving sensitivity but lowering specificity. Appropriate management recommendations for patients with an atypical cytological diagnosis are required.

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“…Among those features, hyperchromasia has consistently been shown to be an independent predictor of HGUCA; however, because it has also been frequently reported in LGUCA, it makes it an essential but nondiscriminatory feature between low-grade and high-grade urothelial lesions. 6,[8][9][10][11][12] Similarly, irregular nuclear membranes, although most often reported in specimens harboring HGUCA, can also be present in LGUCA and even in certain reactive conditions, in particular stone atypia. 4,5,9 At least 3 studies, including the current one, have reported a significant association between pleomorphism and subsequent HGUCA, making it a powerful feature in assessing urine cytology specimens and in differentiating low-grade from high-grade tumors.…”

Section: Discussionmentioning

confidence: 99%

“…In that regard, whereas the vast majority of related studies were qualitative-based, the findings of 2 recent studies seem to indirectly suggest that the number of atypical urothelial cells in a given specimen may determine the histological outcome. 6,7 We herein present a detailed and systematic morphological and quantitative analysis of a large set of urine cytology specimens in order to determine which qualitative and quantitative features are mostly associated with HGUCA.…”

Section: Introductionmentioning

confidence: 99%

Urine cytology: does the number of atypical urothelial cells matter? A qualitative and quantitative study of 112 cases

Brimo

Kassouf

et al. 2015

Journal of the American Society of Cytopathology

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Diagnostic terminology for urinary cytology reports including the new subcategories ‘atypical urothelial cells of undetermined significance’ (AUC‐US) and ‘cannot exclude high grade’ (AUC‐H)

Abstract: We conclude that the new subcategories could help to standardize urine cytopathology reports and contribute to the patient's management, provided it is validated by multicentric studies.

Cited by 79 publications

References 34 publications

Utility of the Paris System in Reporting Urine Cytology

Utility of the Paris System in Reporting Urine Cytology

Applying the Paris System for Reporting Urine Cytology Increases the Rate of Atypical Urothelial Cells in Benign Cases: A Need for Patient Management Recommendations

Urine cytology: does the number of atypical urothelial cells matter? A qualitative and quantitative study of 112 cases

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