The positive predictive value of “suspicious for high‐grade urothelial carcinoma” in urinary tract cytology specimens: A single‐institution study of 665 cases

Abstract

Diagnoses of suspicious for high-grade urothelial carcinoma, as used at the authors' institution, have an ROM that is high but is lower than that for the "positive" category. Therefore, the authors suggest keeping the 2 categories separate, although management should be aggressive in both groups. Cancer Cytopathol 2016;124:811-9. © 2016 American Cancer Society.

The value of the UroVysion® FISH assay in the risk‐stratification of patients with “atypical urothelial cells” in urinary cytology specimens

“…34 Absence of disease was defined as cystoscopically obtained biopsies showing no evidence of malignancy, including those with various degrees of inflammation, granulomas and reactive changes. .…”

“…The inclusion of positive cytology results in the absence of histologic results as evidence for the presence of UC was based on the high specificity of positive UCy results for the presence of UC in our institution. 34 Absence of disease was defined as cystoscopically obtained biopsies showing no evidence of malignancy, including those with various degrees of inflammation, granulomas and reactive changes. When no cystoscopically obtained biopsies were available, negative cystoscopic evaluation with concurrent negative cytology was used to determine the absence of disease.…”

p16/Ki‐67 dual labeling and urinary cytology results according to the New Paris System for Reporting Urinary Cytology: Impact of extended follow‐up

“…27 To date, only a few publications have addressed the impact of TPS on daily laboratory performance or on the clinical management of patients. 28,29 Because of the known overexpression of p16 INK4a in high-grade urothelial lesions, the cell cycle default that is theoretically highlighted by p16/Ki-67 dual labeling, and the potential impact of TPS, the current study was undertaken to investigate whether urine cytology on one hand or p16/Ki-67 on the other hand could help to better classify urothelial lesions and assess the risk of progression to a high grade, infiltration, or upper urinary tract (UUT) extension.…”

“…Normal, inflammatory, reactive, and degenerative conditions of the urothelial component were considered NHGUC, as described by previous studies and actualized in TPS (2015). [26][27][28][29][30] AUC cases (previously recorded as atypical urothelial cells of undetermined significance [AUC-US]) were clearly separated from SHGUC cases (previously recorded as atypical urothelial cells, cannot exclude high-grade urothelial carcinoma [AUC-H]). NHGUC and AUC cases were considered negative results.…”

High‐grade urothelial carcinoma in urine cytology with jet black and smooth or glassy chromatin

“…Urine cytology is a highly accurate test for high-grade urothelial carcinoma (UC), with a sensitivity and specificity as high as 79% and 95%, respectively, [1][2][3][4] although this can vary widely. [5][6][7][8][9][10][11][12][13][14][15][16][17] The Paris System for Reporting Urinary Cytology proposes a standardized terminology [18][19][20][21][22][23] that only seeks to diagnose high-grade UC. 18 To accomplish this, this system uses a single set of strict diagnostic criteria derived from the literature for all high-grade UCs: 1) at least 5 to 10 abnormal cells (at least 10 in the upper tract) 8 ; 2) a nuclear/ cytoplasmic ratio > 0.7 12,24 ; 3) moderate hyperchromasia 8,25,26 ; 4) irregular nuclear membrane 12,24 ; and 5) coarse clumped chromatin.…”