Singh Anu, Khan Adil Aziz, Ahluwalia Charanjeet, Ahuja Sana, Ranga Sunil
Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Acta Cytol. 2024;68(6):525-531. doi: 10.1159/000541504. Epub 2024 Sep 18.
Urinary cytology, a non-invasive screening tool, is essential for detecting high-grade urothelial neoplasms. The Paris System (TPS) standardizes reporting practices to improve diagnostic accuracy. TPS 2.0, introduced in 2022, categorizes samples into six diagnostic groups, emphasizing high-grade urothelial carcinoma (HGUC).
This retrospective study analyzed urine cytology samples from June 2023 to May 2024, correlating with histopathology when available. Samples were classified under TPS 2.0 categories, and statistical metrics including sensitivity, specificity, positive predictive value (PPV), and negative predictive value were calculated for three groups based on malignancy criteria.
Out of 180 samples, the distribution was ND (3.9%), NHGUC (65.6%), AUC (10%), SHGUC (11.7%), and HGUC (8.9%). Histopathological correlation was available for 30.6% of cases. risk of malignancy values were: ND (33.3%), negative for HGUC (29.4%), AUC (66.7%), suspicious for HGUC (94.1%), and HGUC (100%). Group A showed the highest sensitivity (86.49%) and diagnostic accuracy (84.62%), while group C had 100% specificity and PPV.
The study confirms TPS 2.0's efficacy in improving diagnostic accuracy for HGUC, with high specificity and sensitivity. Compared to TPS 1.0, TPS 2.0 offers clearer diagnostic criteria, enhancing clinical decision-making and patient outcomes. The findings support the continued use of TPS 2.0 in clinical practice, ensuring reliable identification of HGUC.
尿细胞学检查作为一种非侵入性筛查工具，对于检测高级别尿路上皮肿瘤至关重要。巴黎系统（TPS）规范了报告流程以提高诊断准确性。2022年推出的TPS 2.0将样本分为六个诊断组，重点关注高级别尿路上皮癌（HGUC）。
这项回顾性研究分析了2023年6月至2024年5月的尿细胞学样本，并在可行时与组织病理学结果进行关联。样本按照TPS 2.0分类，根据恶性标准为三组计算包括敏感性、特异性、阳性预测值（PPV）和阴性预测值在内的统计指标。
在180个样本中，分布情况为：非典型性（ND，3.9%）、非高级别尿路上皮癌（NHGUC，65.6%）、意义不明确的不典型性（AUC，10%）、低级别尿路上皮癌（SHGUC，11.7%）和高级别尿路上皮癌（HGUC，8.9%）。30.6%的病例有组织病理学关联。恶性风险值分别为：ND（33.3%）、HGUC阴性（29.4%）、AUC（66.7%）、HGUC可疑（94.1%）和HGUC（100%）。A组显示出最高的敏感性（86.49%）和诊断准确性（84.62%），而C组的特异性和PPV为100%。
该研究证实了TPS 2.0在提高HGUC诊断准确性方面的有效性，具有高特异性和敏感性。与TPS 1.0相比，TPS 2.0提供了更清晰的诊断标准，增强了临床决策和患者预后。研究结果支持在临床实践中继续使用TPS 2.0，以确保可靠地识别HGUC。
