Jangir Hemlata, Narwal Anubhav, Adhikari Suman Smith, Batra Atul, Nayak Brusabhanu, Seth Amlesh, Kaushal Seema
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India.
Cytopathology. 2025 Mar;36(2):140-149. doi: 10.1111/cyt.13458. Epub 2024 Nov 19.
The objective of this study is to evaluate the diagnostic performance of urine cytology using The Paris System (TPS 2.0) in comparison with TPS 1.0, and the Four-Tier Reporting System (FTRS) of our institute for identifying high-grade urothelial carcinoma (HGUC).
A total of 789 urine cytology specimens from 240 patients including 12 UTUC cases with available histological and clinical details were included. Two hundred twenty-two cases were newly diagnosed, whereas 18 were recurrent tumours. Histopathological evaluation categorised the cases as non-neoplastic (33%, 13.7%), low-grade urothelial neoplasms (LGUNs) (94%, 39.2%), high-grade urothelial carcinoma (HGUCs) (110%, 45.8%) and other malignancies (3%, 1.3%).
TPS 2.0 categorised the cases as 14 (5.7%) non-diagnostic or ND/U, 99 (41.5%) NHGUC, 37 (15.4%) AUC, 24 (10%) SHGUC and 66 (27.5%) HGUC. TPS 1.0 had 14 (5.7%) ND/U, 72 (30%) NHGUC, 61 (24.5%) AUC, 3 (1.3%) LGUC, 24 (10%) SHGUC and 66 (27.5%) HGUC. FTRS classified them as 19 (7.5%) ND/UNS, 44 (18.3%) NEG, 88 (36.7%) INC and 89 (37.1%) POS. The ROHM for TPS 2.0 was 71.4% for ND/U, 12.1% for NHGUC, 29.7% for AUC, 79.2% for SHGUC and 89.4% for HGUC. TPS 1.0 showed a similar ROHM for ND/U, SHGUC and HGUC, whereas had 13.8% for NHGUC and 19.7% for AUCs. FTRS, had 78.9% for UNS, 6.8% for NEG, 35.2% for INC and 73.1% for POS. TPS demonstrated a sensitivity of 70.91% and specificity of 90.77% for identifying HGUC, whereas FTRS showed 59.09% sensitivity and 81.54% specificity. Also, TPS was found to be 75% accurate with 62.5% sensitivity and 100% specificity for UTCC cases separately.
TPS 2.0 exhibits diagnostic accuracy with better performance in comparison to FTRS, making it a more reliable system for clinical practice. Our findings endorse the utility of TPS 2.0 in improving the accuracy of urine cytology in predicting histological diagnosis of HGUC.
本研究旨在评估使用巴黎系统（TPS 2.0）的尿液细胞学诊断性能，并与TPS 1.0以及本研究所的四级报告系统（FTRS）进行比较，以识别高级别尿路上皮癌（HGUC）。
共纳入240例患者的789份尿液细胞学标本，其中包括12例有可用组织学和临床细节的上尿路尿路上皮癌（UTUC）病例。222例为新诊断病例，18例为复发性肿瘤。组织病理学评估将病例分类为非肿瘤性（33%，13.7%）、低级别尿路上皮肿瘤（LGUNs）（94%，39.2%）、高级别尿路上皮癌（HGUCs）（110%，45.8%）和其他恶性肿瘤（3%，1.3%）。
TPS 2.0将病例分类为14例（5.7%）无法诊断或ND/U、99例（41.5%）非高级别尿路上皮癌（NHGUC）、37例（15.4%）非典型尿路上皮细胞（AUC）、24例（10%）高级别尿路上皮癌（SHGUC）和66例（27.5%）HGUC。TPS 1.0有14例（5.7%）ND/U、72例（30%）NHGUC、61例（24.5%）AUC、3例（1.3%）LGUC、24例（10%）SHGUC和66例（27.5%）HGUC。FTRS将它们分类为19例（7.5%）ND/UNS、44例（18.3%）阴性（NEG）、88例（36.7%）不确定（INC）和89例（37.
