Kavas Gamze, Celik Betül
Department of Pathology, Bitlis Tatvan State Hospital, Health Sciences University, Istanbul, Turkey.
Department of Pathology, Antalya Training and Research Hospital, Health Sciences University, Antalya, Turkey.
Acta Cytol. 2024;68(6):544-554. doi: 10.1159/000541983. Epub 2024 Oct 15.
The Paris System for Reporting Urinary Cytology (TPS) was designed to provide precise diagnostic criteria when evaluating urine cytology and standardize the terminology used in reporting. In our study, we have aimed to determine the effect of TPS on the diagnostic performance of urine cytology, its impact on establishing appropriate risk stratification, and its effectiveness in the diagnosis and follow-up of the patients.
We reevaluated 200 liquid-based urine cytologies with available histological diagnoses reported between 2015 and 2021 according to TPS criteria and compared them with the original cytological diagnoses. Area under the curve, sensitivity, specificity, and diagnostic accuracy of both methods were calculated and statistically analyzed to determine the diagnostic performance of the original reporting and TPS.
The sensitivity, specificity, positive predictive, negative predictive, and diagnostic accuracy rates of TPS were 60%, 99.3%, 97.2%, 97.2%, 85.7%, and 87.2%, respectively. In TPS, the risk of malignancy for negative for high-grade urothelial carcinoma, atypical urothelial cells, suspicious for high-grade urothelial carcinoma, and high-grade urothelial carcinoma (HGUC) is 3.5%, 20.9%, 60.8%, 97.2%, respectively. In the original reporting, the corresponding risks were 13.4%, 15%, 52%, 100%, respectively. A statistically significant difference was observed between diagnostic criteria of original cytology and TPS (p = 0.001). When the original reporting was compared with the TPS, the discriminative power of TPS in the diagnosis of HGUC was significantly higher (p < 0.001).
The use of TPS provided a more accurate risk stratification of patients. The diagnostic performance of urine cytology was improved, especially for HGUC.
巴黎泌尿系统细胞学报告系统（TPS）旨在为评估尿液细胞学提供精确的诊断标准，并规范报告中使用的术语。在我们的研究中，我们旨在确定TPS对尿液细胞学诊断性能的影响、其对建立适当风险分层的影响以及其在患者诊断和随访中的有效性。
我们根据TPS标准重新评估了200例2015年至2021年间报告的有可用组织学诊断的液基尿液细胞学检查，并将其与原始细胞学诊断进行比较。计算并统计分析两种方法的曲线下面积、敏感性、特异性和诊断准确性，以确定原始报告和TPS的诊断性能。
TPS的敏感性分别为60%，特异性为99.3%，阳性预测值为97.2%，阴性预测值为97.2%，诊断准确率为85.7%和87.2%。在TPS中，高级别尿路上皮癌阴性、非典型尿路上皮细胞、高级别尿路上皮癌可疑和高级别尿路上皮癌（HGUC）的恶性风险分别为3.5%、20.9%、60.8%、97.2%。在原始报告中，相应的风险分别为13.4%、15%、52%、100%。原始细胞学诊断标准与TPS之间观察到统计学显著差异（p = 0.001）。当将原始报告与TPS进行比较时，TPS在HGUC诊断中的鉴别能力显著更高（p < 0.001）。
使用TPS为患者提供了更准确的风险分层。尿液细胞学的诊断性能得到了改善，尤其是对于HGUC。
