Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts; Breast Oncology Program, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts.
Department of Pathology and Laboratory Medicine, Loyola University Healthcare System, Maywood, Illinois; Department of Urology, Loyola University Healthcare System, Maywood, Illinois.
J Am Soc Cytopathol. 2021 Jan-Feb;10(1):79-87. doi: 10.1016/j.jasc.2020.10.002. Epub 2020 Oct 10.
The Paris System for Reporting Urinary Cytology (TPS) was first published in 2016 with clear objectives to standardize cytologic diagnostic criteria and provide uniform reporting, in order to improve patient stratification and associated clinical management. The aim of this paper is to evaluate the performance of TPS and review the literature published since TPS was introduced.
Original articles focusing on the utilization and performance of TPS in urinary cytology specimens were identified using PubMed for publications from January 2016 to July 2020, using the keywords "Paris System", "urine cytology", and "urinary cytology".
Twenty-three relevant articles in the literature regarding the use of TPS were included in the review from a total of 30,802 urine cytology specimens, of which 21,485 (69.8%) had available diagnoses. Distribution of cases among categories ranged from 50.5% to 95.3% for negative for high-grade urothelial carcinoma (NHGUC), 1.2% to 23% for atypical urothelial cells (AUC), 0.2% to 6.6% for suspicious for high-grade urothelial carcinomas (SHGUC), and 2.2% to 14.1% for high-grade urothelial carcinomas (HGUC). The calculated risk of high-grade malignancy (ROHM) ranged from 8.7% to 36.8% for NHGUC, 12.3% to 60.9%% for AUC, 33.3% to 100% for SHGUC, and 58.8% to 100% for HGUC. Mean ROHM weighted by sample size was calculated at 15.7% (±7.8%), 38.5% (±14.3%), 76.2% (±17.2%), and 88.8% (±12.7%) for NHGUC, AUC, SHGUC, and HGUC, respectively. Reported sensitivity of TPS ranged from 40% to 84.7%, specificity from 73% to 100%, PPV from 62.3% to 100%, and NPV from 46% to 90%.
The application of TPS in the selected series has improved the screening and surveillance potential of urine cytology, while reducing high rates of indeterminate diagnoses, improving sensitivity and providing proper risk stratification for patients.
巴黎泌尿系统细胞学报告系统（TPS）于 2016 年首次发布，其明确目标是规范细胞学诊断标准并提供统一报告，以改善患者分层和相关临床管理。本文旨在评估 TPS 的性能，并回顾自 TPS 引入以来发表的文献。
使用 PubMed 数据库，以“巴黎系统”、“尿液细胞学”和“尿液细胞学”为关键词，检索 2016 年 1 月至 2020 年 7 月期间发表的关于 TPS 在尿细胞学标本中应用和性能的原始文章。
从 30802 例尿细胞学标本中，共检索到 23 篇关于 TPS 使用的相关文献综述，其中 21485 例（69.8%）有明确诊断。各分类病例分布范围为：阴性高级尿路上皮癌（NHGUC）为 50.5%至 95.3%，非典型尿路上皮细胞（AUC）为 1.2%至 23%，可疑高级尿路上皮癌（SHGUC）为 0.2%至 6.6%，高级尿路上皮癌（HGUC）为 2.2%至 14.1%。高级恶性风险（ROHM）计算范围为 NHGUC 为 8.7%至 36.8%，AUC 为 12.3%至 60.9%，SHGUC 为 33.3%至 100%，HGUC 为 58.8%至 100%。按样本量加权平均 ROHM 分别为 NHGUC 为 15.7%（±7.8%），AUC 为 38.5%（±14.3%），SHGUC 为 76.2%（±17.2%），HGUC 为 88.8%（±12.7%）。TPS 的报告敏感性范围为 40%至 84.7%，特异性为 73%至 100%，阳性预测值为 62.3%至 100%，阴性预测值为 46%至 90%。
在所选系列中应用 TPS 提高了尿细胞学的筛查和监测潜力，同时降低了不确定诊断的高比例，提高了敏感性，并为患者提供了适当的风险分层。
