Department of Pathology & Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Cytopathology. 2020 Jan;31(1):35-40. doi: 10.1111/cyt.12777. Epub 2019 Dec 8.
The development of the Paris System (TPS) has provided a standard and reproducible system for reporting urine cytopathology. Our goal was to study the impact of TPS on the diagnostic accuracy of urine cytology since we began using it in 2016.
We performed a retrospective study of all urine cytology specimens received at our institution from January 2015 through July 2017. Cases were included in the study if they had corresponding surgical pathology follow up. In total, 3829 cases were identified over this time period, with 381 cases meeting inclusion criteria, comprising 87 cases from 2015, 166 from 2016 and 128 from 2017. Using the histopathology diagnosis as the gold standard, sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and diagnostic accuracy (DA) for the detection of carcinoma were calculated.
Before TPS, urine cytology had a sensitivity of 100.0%, specificity of 12.5%, PPV of 83.5%, NPV of 100.0% and DA of 83.9%. After TPS, for 2016, urine cytology had sensitivity of 87.1%, specificity of 95.9%, PPV of 96.4%, NPV of 85.4% and DA of 91.0%. For 2017 after TPS, the sensitivity was 81.7%, specificity was 100.0%, PPV was 100.0%, NPV was 81.4% and DA was 89.8%.
For the detection of urinary tract malignancy, after switching to TPS, we observed a marked increase in urine cytology specificity and PPV, both of which continued to gradually increase from 2016 to 2017. The DA also improved with TPS.
巴黎系统（TPS）的发展为尿细胞学报告提供了一个标准且可重复的系统。自 2016 年开始使用 TPS 以来，我们的目标是研究 TPS 对尿细胞学诊断准确性的影响。
我们对 2015 年 1 月至 2017 年 7 月期间我院收到的所有尿细胞学标本进行了回顾性研究。如果这些病例有相应的手术病理随访，就将其纳入研究。在此期间，共发现 3829 例病例，其中 381 例符合纳入标准，包括 2015 年的 87 例、2016 年的 166 例和 2017 年的 128 例。以组织病理学诊断为金标准，计算出检测癌的敏感性、特异性、阴性预测值（NPV）、阳性预测值（PPV）和诊断准确性（DA）。
在 TPS 之前，尿细胞学的敏感性为 100.0%，特异性为 12.5%，PPV 为 83.5%，NPV 为 100.0%，DA 为 83.9%。在 TPS 之后，2016 年尿细胞学的敏感性为 87.1%，特异性为 95.9%，PPV 为 96.4%，NPV 为 85.4%，DA 为 91.0%。2017 年 TPS 后，敏感性为 81.7%，特异性为 100.0%，PPV 为 100.0%，NPV 为 81.4%，DA 为 89.8%。
在切换到 TPS 后，我们观察到尿细胞学的特异性和 PPV 明显提高，用于检测尿路恶性肿瘤，这两项指标在 2016 年至 2017 年期间持续逐渐上升，而 TPS 后 DA 也有所提高。
