Nikas Ilias P, Seide Svenja, Proctor Tanja, Kleinaki Zoi, Kleinaki Maria, Reynolds Jordan P
School of Medicine, European University Cyprus, Nicosia 2404, Cyprus.
Institute of Medical Biometry, University of Heidelberg, 69120 Heidelberg, Germany.
J Pers Med. 2022 Jan 27;12(2):170. doi: 10.3390/jpm12020170.
The Paris System (TPS) for Reporting Urinary Cytology is a standardized, evidence-based reporting system, comprising seven diagnostic categories: nondiagnostic, negative for high-grade urothelial carcinoma (NHGUC), atypical urothelial cells (AUC), suspicious for high-grade urothelial carcinoma (SHGUC), HGUC, low-grade urothelial neoplasm (LGUN), and other malignancies. This study aimed to calculate the pooled risk of high-grade malignancy (ROHM) of each category and demonstrate the diagnostic accuracy of urine cytology reported with TPS. Four databases (PubMed, Embase, Scopus, Web of Science) were searched. Specific inclusion and exclusion criteria were applied, while data were extracted and analyzed both qualitatively and quantitatively. The pooled ROHM was 17.70% for the nondiagnostic category (95% CI, 0.0650; 0.3997), 13.04% for the NHGUC (95% CI, 0.0932; 0.1796), 38.65% for the AUC (95% CI, 0.3042; 0.4759), 12.45% for the LGUN (95% CI, 0.0431; 0.3101), 76.89 for the SHGUC (95% CI, 0.7063; 0.8216), and 91.79% for the HGUC and other malignancies (95% CI, 0.8722; 0.9482). A summary ROC curve was created and the Area Under the Curve (AUC) was 0.849, while the pooled sensitivity was 0.669 (95% CI, 0.589; 0.741) and false-positive rate was 0.101 (95% CI, 0.063; 0.158). In addition, the pooled DOR of the included studies was 21.258 (95% CI, 14.336; 31.522). TPS assigns each sample into a diagnostic category linked with a specific ROHM, guiding clinical management.
巴黎泌尿系统细胞学报告系统（TPS）是一个标准化的、基于证据的报告系统，包括七个诊断类别：无法诊断、高级别尿路上皮癌阴性（NHGUC）、非典型尿路上皮细胞（AUC）、高级别尿路上皮癌可疑（SHGUC）、高级别尿路上皮癌（HGUC）、低级别尿路上皮肿瘤（LGUN）和其他恶性肿瘤。本研究旨在计算每个类别的高级别恶性肿瘤合并风险（ROHM），并证明采用TPS报告的尿液细胞学诊断准确性。检索了四个数据库（PubMed、Embase、Scopus、Web of Science）。应用了特定的纳入和排除标准，同时对数据进行了定性和定量提取与分析。无法诊断类别的合并ROHM为17.70%（95%CI，0.0650；0.3997），NHGUC为13.04%（95%CI，0.0932；0.1796），AUC为38.65%（95%CI，0.3042；0.4759），LGUN为12.45%（95%CI，0.0431；0.3101），SHGUC为76.89%（95%CI，0.7063；0.8216），HGUC和其他恶性肿瘤为91.79%（95%CI，0.8722；0.9482）。创建了汇总ROC曲线，曲线下面积（AUC）为0.849，合并敏感度为0.669（95%CI，0.589；0.741），假阳性率为0.101（95%CI，0.063；0.158）。此外，纳入研究的合并诊断比值比为21.258（95%CI，14.336；31.522）。TPS将每个样本归入与特定ROHM相关的诊断类别，指导临床管理。
