Negative predictive value and sensitivity of urine cytology prior to implementation of The Paris System for Reporting Urinary Cytology

McIntire, Patrick J.; Khan, Reema; Hussain, Hamad; Pambuccian, Stefan E.; Wojcik, Eva M.; Barkan, Güliz A.

doi:10.1002/cncy.22102

Cited by 29 publications

(27 citation statements)

References 37 publications

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“…Similar percentages of inadequate samples have been reported in other studies, 24,26 although some researchers report total absence of inadequate samples 21 . The TPS criteria of adequacy and the clinical practices for specimen collection with a suggested volume of >30 mL for voided urine have been discussed, 27,28 yet the elimination of the TPS1 category is not feasible.…”

Section: Discussionsupporting

confidence: 55%

“…However, this referred to a general urinary cytology material, without any inclusion criteria, apart from histology available for correlation. Other groups have reported similar or higher values, although using different study material, 22,24,26,27,30,31 which renders comparison not feasible.…”

Section: Discussionmentioning

confidence: 93%

“…[21][22][23] Our estimated risk of malignancy (ROM) for HGUC was 0% for 24,26 although some researchers report total absence of inadequate samples. 21 The TPS criteria of adequacy and the clinical practices for specimen collection with a suggested volume of >30 mL for voided urine have been discussed, 27,28 low sensitivity of urinary cytology for low-grade tumors, 29 which has been the basic idea for the formulation of the TPS as a reporting system focusing on HGUC detection. 10,11 The estimated ROM was 6.5%, 24,26 In our previous study, addressing the impact of the TPS in the "atypical" group we have documented a significant decrease in the proportion of atypical diagnoses.…”

Section: Discussionmentioning

confidence: 99%

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Risk of malignancy assessment for the Paris System for reporting urinary cytology

Moulavasilis

Lazaris

Katafigiotis

et al. 2020

Diagnostic Cytopathology

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Background: The Paris System for reporting urinary cytology was introduced in 2013 and has a global impact. In our study, we assess the risk of malignancy (ROM) for each diagnostic category and our diagnostic accuracy in urinary cytology. Methods: We have conducted a prospective study during 2019, including only new cases of urothelial neoplasms, all of them with subsequent histology. The risk of malignancy for each category was calculated and the diagnostic accuracy parameters were estimated in correlation with histology. Results: The estimated risk of malignancy (ROM) for high-grade neoplasms was 0% for TPS1, 6.5% (2/31) for TPS2, 36% (9/25) for TPS3, 65% (13/20) for TPS4, 100% (18/18) for TPS5 and 16% (2/13) for TPS6. Accuracy parameters for high-grade urothelial carcinoma (HGUC) were evaluated in two ways, in the first considering TPS3 as a negative and in the second as a positive result and the values were: sensitivity 70% vs 90.9%, specificity 89.3% vs 65.2%, PPV 81.5% vs 63.5%, NPV 82% vs 91.5% and diagnostic accuracy 81.8% vs 75.4%. For low-grade urothelial neoplasm (LGUN) diagnosis, sensitivity was 42%, specificity 76%, PPV 71%, NPV 48.6% and diagnostic accuracy 56%. Conclusion: The risk of malignancy for the TPS categories has a clinically meaningful gradation and the effectiveness of urinary cytology is improved by the application of the Paris System.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Risk of malignancy assessment for the Paris System for reporting urinary cytology

Moulavasilis

Lazaris

Katafigiotis

et al. 2020

Diagnostic Cytopathology

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“…These classification systems emerged in harmony with the histological classification used for bladder tumors. It is well known that some of the shortcomings of urinary cytopathology, particularly low sensitivity in detecting low-grade non-invasive lesions, make urinary cytology samples one of the more difficult specimens encountered in cytopathology [ 38 , 39 , 40 ]. Difficulties also arise from low cellularity of smears and pre-fixation cellular deterioration.…”

Section: ⧉ Urinary Cytology the Paris Systemmentioning

confidence: 99%

Current classification systems and standardized terminology in cytopathology

Mezei

2021

Rom J Morphol Embryol

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The history of classification systems and the search for a unified nomenclature in cytopathology spans several decades and expresses the preoccupation of all those involved to make cytopathology a reliable diagnostic tool and a trusted screening method. Early classification schemes, applicable to exfoliative and aspiration cytology, attempted to set some basic standards for how non-gynecological cytopathology findings should be reported. While useful in establishing some basic guidelines, these were not specific to the various fields of nongynecologic cytopathology, often burdened with specific problems. Cytopathology has evolved tremendously in the last couple of decades, undoubtedly boosted by the emergence of various classification schemes that, more than ever, are based on evidence gathered by professionals across the globe. The benefit of classification systems and standardized nomenclature in cytopathology is to provide useful, clear, and clinically relevant information for clinicians and ultimately to provide the best patient care. Standardized reporting systems make cytopathology reports more meaningful and robust. It now became standard that these include by default elements, such as adequacy criteria, diagnostic groups, risk of malignancy (ROM), and recommendations for patient management. In this brief review, we attempted to summarize how these classification schemes emerged and how they are reshaping the landscape of diagnostic cytopathology.

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“…The sensitivity and specificity of cytology for detecting low‐grade tumors are approximately 30% and 80%, respectively 10 . In practice, specimens from patients without tumors far outnumber those from patients with tumors.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of a comprehensive, urothelial carcinoma–specific next‐generation sequencing panel in urine cytology and bladder tumor specimens

Hutchinson

Tomaszewicz

Caporelli

et al. 2021

Cancer Cytopathology

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Background Urine cytology can reliably diagnose high‐grade urothelial carcinoma (HGUC) but not low‐grade urothelial carcinoma (LGUC), and a more sensitive test is needed. Previously, a pilot study highlighted the possible diagnostic utility of next‐generation sequencing (NGS) in identifying both LGUC and HGUC in urine cytology specimens. Methods Twenty‐eight urine ThinPrep cytology specimens and preceding or subsequent bladder tumor biopsy/resection specimens obtained within 3 months were included in the study (LGUC, n = 15; HGUC, n = 13). A customized, bladder‐specific NGS panel was performed; it covered 69 frequently mutated or altered genes in urothelial carcinoma (UC) that were reported by The Cancer Genome Atlas and the Catalogue of Somatic Mutations in Cancer. Results The sequencing results were compared between the urine cytology specimens and the corresponding bladder tumor biopsies/resections. TP53 was the most frequently identified mutation in HGUC cases (11 of 13 [85%]). PIK3CA and KDM6A were the most frequently identified mutations in LGUC: they occurred in 7 of 15 cases (47%) and in 6 of 15 cases (40%), respectively. Additional frequent mutations identified in the panel included ARID1A (n = 5), EP300 (n = 4), LRP1B (n = 3), ERBB2 (n = 2), STAG2 (n = 2), FGFR3 (n = 3), MLL (n = 2), MLL3 (n = 2), CREBBP1 (n = 1), RB1 (n = 1), and FAT4 (n = 1). Overall, the concordance between the cytology and surgical specimens was 75%. The sensitivity and specificity for identifying mutations in urine cytology specimens were 84% and 100%, respectively. Conclusions A bladder‐specific NGS panel increases the sensitivity and specificity of urine cytology's diagnostic utility in both low‐ and high‐grade tumors and may serve as a noninvasive surveillance method in the follow‐up of patients with UC harboring known mutations.

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Negative predictive value and sensitivity of urine cytology prior to implementation of The Paris System for Reporting Urinary Cytology

Cited by 29 publications

References 37 publications

Risk of malignancy assessment for the Paris System for reporting urinary cytology

Risk of malignancy assessment for the Paris System for reporting urinary cytology

Current classification systems and standardized terminology in cytopathology

Diagnostic value of a comprehensive, urothelial carcinoma–specific next‐generation sequencing panel in urine cytology and bladder tumor specimens

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