Chen L, Liu L T, Sun M J, He S R, Liu D G
Department of Pathology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Bing Li Xue Za Zhi. 2024 May 8;53(5):470-476. doi: 10.3760/cma.j.cn112151-20231012-00251.
To validate the diagnostic performance of the Paris system for reporting urinary cytology (TPS). A total of 7 046 urine cytology samples from 3 402 patients collected in the Department of Pathology, Beijing Hospital, China from January 2020 to January 2022 were analyzed. 488 patients had a biopsy or resection specimen during the follow-up period of 6 months. The sensitivity, specificity, risk of malignancy (ROM) and risk of high-grade malignancy (ROHM) of the TPS were evaluated using histological diagnosis as the golden standard. Among the 7 046 samples, high-grade urothelial carcinoma (HGUC) accounted for 5.7% (399/7 046), suspicious for high-grade urothelial carcinoma (SHGUC) for 3.2% (227/7 046), atypical urothelial cells (AUC) for 8.4% (593/7 046), and negative for high-grade urothelial carcinoma (NHGUC) for 72.9% (5 139/7 046) including low-grade urothelial neoplasm (LGUN) for 0.8% (59/7 046) and insufficient samples for 9.8% (688/7 046). 488 patients had a bladder biopsy or resection in the follow-up of six months, including 314 males and 174 females, aged 27 to 92 years (average, 66 years). The ROHM of TPS was 94.7% in HGUC, 83.3% in SHGUC, 41.3% in AUC and 18.8% in NHGUC. The sensitivity and specificity of urine cytology were 70.1% (169/241) and 97.0% (162/167), respectively. The negative predictive value of NHGUC was 69.2% (162/234). The study has shown that TPS classification has high sensitivity and specificity, high ROHM for HGUC and SHGUC, and high negative predictive value for NHGUC. The application of TPS reporting system can better interpret the clinical significance of cytology samples, improve the accuracy of urine cytopathology and ensure continuous diagnostic consistency.
为验证巴黎系统报告尿细胞学检查结果（TPS）的诊断性能。对2020年1月至2022年1月在中国北京医院病理科收集的3402例患者的7046份尿细胞学样本进行了分析。488例患者在6个月的随访期内进行了活检或切除标本检查。以组织学诊断为金标准，评估TPS的敏感性、特异性、恶性风险（ROM）和高级别恶性风险（ROHM）。在7046份样本中，高级别尿路上皮癌（HGUC）占5.7%（399/7046），可疑高级别尿路上皮癌（SHGUC）占3.2%（227/7046），非典型尿路上皮细胞（AUC）占8.4%（593/7046），高级别尿路上皮癌阴性（NHGUC）占72.9%（5139/7046），其中低级别尿路上皮肿瘤（LGUN）占0.8%（59/7046），样本不足占9.8%（688/7046）。488例患者在6个月的随访中进行了膀胱活检或切除，其中男性314例，女性174例，年龄27至92岁（平均66岁）。TPS在HGUC中的ROHM为94.7%，在SHGUC中为83.3%，在AUC中为41.3%，在NHGUC中为18.8%。尿细胞学检查的敏感性和特异性分别为70.1%（169/241）和97.0%（162/167）。NHGUC的阴性预测值为69.2%（162/234）。该研究表明，TPS分类具有高敏感性和特异性，对HGUC和SHGUC具有高ROHM，对NHGUC具有高阴性预测值。TPS报告系统的应用可以更好地解释细胞学样本的临床意义，提高尿细胞病理学的准确性，并确保诊断的持续一致性。
