Department of Pathology, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China.
Cytopathology. 2020 Sep;31(5):457-462. doi: 10.1111/cyt.12827. Epub 2020 May 7.
In 2013, The Paris System for Reporting Urinary Cytology (TPS) was developed as a uniform practical urine cytology system that could be applied worldwide. Here, we investigated the effectiveness of TPS diagnostic approach compared with that of the traditional urine cytological diagnosis method used in China.
Based on the diagnostic criteria of TPS, 412 urine samples from 143 patients with histological follow-up data were retrospectively analysed, and the diagnoses were compared with the original cytological diagnoses.
In total, 110 patients were histologically diagnosed with high-grade urothelial carcinoma (HGUC), and 33 patients were diagnosed with low-grade urothelial neoplasia. Based on the traditional urine cytological analysis method, 50 patients (34.9%) were diagnosed as negative, 48 patients (33.6%) were diagnosed as having atypical urothelial cells, and 45 patients (31.5%) were diagnosed as positive. After reclassification using TPS, urine samples from 11 cases (7.7%) were categorised as unsatisfactory, 34 cases (23.8%) were negative, 21 cases (14.7%) were categorised as having atypical urothelial cells, 12 cases (8.4%) were diagnosed as suspicious for HGUC, 59 cases (41.2%) were diagnosed with HGUC, and six cases (4.2%) were reclassified as having low-grade urothelial neoplasia. Thus, after implementing TPS criteria, the sensitivity for positive malignancy diagnoses (HGUC alone) increased from 38.2% to 50.9%, while the specificity of the diagnosis was barely changed.
The Paris System for Reporting Urinary Cytology greatly contributes to the standardisation of urine cytology reports and significantly improves the diagnostic sensitivity for HGUC.
2013 年，巴黎尿细胞学报告系统（TPS）作为一种全球通用的实用尿细胞学系统被开发出来。在这里，我们研究了 TPS 诊断方法与中国传统尿细胞学诊断方法的有效性。
基于 TPS 的诊断标准，对 143 例有组织学随访数据的 412 例尿样进行回顾性分析，并将诊断结果与原始细胞学诊断进行比较。
共 110 例患者经组织学诊断为高级别尿路上皮癌（HGUC），33 例患者诊断为低级别尿路上皮肿瘤。根据传统的尿细胞学分析方法，50 例（34.9%）患者诊断为阴性，48 例（33.6%）患者诊断为非典型尿路上皮细胞，45 例（31.5%）患者诊断为阳性。采用 TPS 重新分类后，11 例（7.7%）尿样分类为不满意，34 例（23.8%）为阴性，21 例（14.7%）为非典型尿路上皮细胞，12 例（8.4%）为疑似 HGUC，59 例（41.2%）为 HGUC，6 例（4.2%）为低级别尿路上皮肿瘤。因此，实施 TPS 标准后，阳性恶性肿瘤诊断（仅 HGUC）的敏感性从 38.2%提高到 50.9%，而诊断的特异性几乎没有变化。
巴黎尿细胞学报告系统大大有助于尿细胞学报告的标准化，并显著提高了 HGUC 的诊断敏感性。
