Abstract：
BACKGROUND: The Paris System (TPS) provides a uniform reporting system of urine cytology based on well-defined cytologic criteria. Due to their rarity, there are limited data on the utility of TPS in upper urinary tract (UUT) lesions and follow-up histology of cases with abnormal cytology. We aimed to evaluate the utility of TPS for UUT lesions by correlating the cytologic diagnoses using TPS criteria with subsequent histology. Additionally, the diagnostic utility of UroVysion (Abbott) fluorescence in situ hybridization (FISH) was assessed.
METHODS: A total of 148 UUT cytology specimens were retrospectively identified (2018-2022). Cytologic interpretation was performed using TPS, and then correlated with the findings of concurrent or subsequent histologic specimens. The performance of UroVysion FISH was analyzed. Sensitivity and specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting high-grade urothelial carcinoma (HGUC) were determined.
RESULTS: Among 83 patients who had concurrent or subsequent histologic specimens, cyto-histologic discrepancy was seen in 7 cases (8.4%). The sensitivity, specificity, PPV, and NPV using TPS criteria for detecting HGUC were 87%, and 92%, 96.4%, and 73%, respectively. UroVysion FISH was performed in 21 patients with atypical cytologic findings. The sensitivity and specificity of UroVysion for detecting HGUC was 75% and 86%, respectively, while PPV and NPV were 86% and 75%, respectively.
CONCLUSIONS: In our experience, the application of TPS criteria for reporting upper urinary cytology was reliable at detecting UUT lesions, especially HGUC. UroVysion FISH was a valuable ancillary test for detecting HGUC of UUT.
METHODS: A total of 148 UUT cytology specimens were retrospectively identified (2018-2022). Cytologic interpretation was performed using TPS, and then correlated with the findings of concurrent or subsequent histologic specimens. The performance of UroVysion FISH was analyzed. Sensitivity and specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting high-grade urothelial carcinoma (HGUC) were determined.
RESULTS: Among 83 patients who had concurrent or subsequent histologic specimens, cyto-histologic discrepancy was seen in 7 cases (8.4%). The sensitivity, specificity, PPV, and NPV using TPS criteria for detecting HGUC were 87%, and 92%, 96.4%, and 73%, respectively. UroVysion FISH was performed in 21 patients with atypical cytologic findings. The sensitivity and specificity of UroVysion for detecting HGUC was 75% and 86%, respectively, while PPV and NPV were 86% and 75%, respectively.
CONCLUSIONS: In our experience, the application of TPS criteria for reporting upper urinary cytology was reliable at detecting UUT lesions, especially HGUC. UroVysion FISH was a valuable ancillary test for detecting HGUC of UUT.
摘要：
背景：巴黎系统（TPS）提供了基于明确定义的细胞学标准的尿液细胞学统一报告系统。由于它们的稀有性,关于TPS在上尿路（UUT）病变中的实用性以及细胞学异常病例的随访组织学数据有限。我们旨在通过将使用TPS标准的细胞学诊断与随后的组织学相关联来评估TPS对UUT病变的实用性。此外,评估了UroVysion(Abbott)荧光原位杂交(FISH)的诊断实用性.
方法：回顾性鉴定了148个UUT细胞学标本（2018-2022年）。使用TPS进行细胞学解释，然后与同时或随后的组织学标本的发现相关。分析了UroVysionFISH的性能。敏感性和特异性，确定了检测高级别尿路上皮癌（HGUC）的阳性预测值（PPV）和阴性预测值（NPV）。
结果：在83例同时或随后有组织学标本的患者中，7例（8.4％）出现细胞组织学差异。敏感性,特异性，PPV,使用TPS标准检测HGUC的NPV为87%，92%,96.4%,73%,分别。对21例具有非典型细胞学检查结果的患者进行了尿路FISH检查。UroVysion检测HGUC的敏感性和特异性分别为75%和86%,分别,而PPV和NPV分别为86%和75%，分别。
结论：根据我们的经验，应用TPS标准报告上尿细胞学在检测UUT病变方面是可靠的，尤其是HGUC。UroVysionFISH是检测UUT的HGUC的有价值的辅助测试。
方法：回顾性鉴定了148个UUT细胞学标本（2018-2022年）。使用TPS进行细胞学解释，然后与同时或随后的组织学标本的发现相关。分析了UroVysionFISH的性能。敏感性和特异性，确定了检测高级别尿路上皮癌（HGUC）的阳性预测值（PPV）和阴性预测值（NPV）。
结果：在83例同时或随后有组织学标本的患者中，7例（8.4％）出现细胞组织学差异。敏感性,特异性，PPV,使用TPS标准检测HGUC的NPV为87%，92%,96.4%,73%,分别。对21例具有非典型细胞学检查结果的患者进行了尿路FISH检查。UroVysion检测HGUC的敏感性和特异性分别为75%和86%,分别,而PPV和NPV分别为86%和75%，分别。
结论：根据我们的经验，应用TPS标准报告上尿细胞学在检测UUT病变方面是可靠的，尤其是HGUC。UroVysionFISH是检测UUT的HGUC的有价值的辅助测试。
