目的:由于器械伪影,上尿路(UUT)的细胞学评估可能具有挑战性。这项研究使用巴黎尿路细胞病理学报告系统回顾性审查了UUT标本,第二版(TPS2.0),将其与原始报告系统(ORS)进行比较,并将其与组织病理学随访相关联。
方法:审查了UUT活检/切除组织病理学标本的机构数据库,我们纳入了52份与这些病例相关的UUT细胞学标本.使用TPS2.0对这些标本进行了盲目审查和重新分类。评估TPS2.0,ORS与组织病理学随访之间的相关性。
结果:UUT细胞学标本对应于21(40.4%)高级别尿路上皮癌(HGUC),27例(51.9%)低度级别尿路上皮癌(LGUC)和4例(7.7%)良性随访。对于HGGC案例,相关的TPS类别包括不满意(n=1,4.8%),HGUC阴性(NHGUC;n=3,14.3%),非典型尿路上皮细胞(AUC;n=6,28.6%),怀疑HGUC(SHGUC;n=3,14.3%)和HGUC(n=8,38.1%),而ORS将标本归类为不合格(n=1,4.8%),恶性细胞阴性(NFMC;n=3,14.3%),AUC(n=5,23.8%),低级别尿路上皮癌(LGUC;n=0,0%),SHGUC(n=5,23.8%)和HGUC(n=7,33.3%)。ORS和TPS在细胞学类别中高级别恶性肿瘤的风险相似(p>0.05)。大多数LGUC被ORS和TPS分类为AUC(55.6%vs.59.3%)。
结论:我们的研究表明TPS2.0和ORS对UUT细胞学标本具有相当的性能。UUT标本的细胞学诊断仍然具有挑战性,尤其是LGUC。
OBJECTIVE: Cytologic evaluation of the upper urinary tract (UUT) can be challenging due to instrumentation artefacts. This
study retrospectively reviewed UUT specimens using The Paris System for Reporting Urinary Cytopathology, second edition (TPS 2.0), compared it with the original reporting system (ORS) and correlated it with histopathologic follow-up.
METHODS: An institutional database was reviewed for the UUT biopsy/resection histopathologic specimens, and we included 52 UUT cytology specimens pertinent to these cases in the
study. These specimens were blindly reviewed and reclassified using TPS 2.0. The correlation between TPS 2.0, ORS and histopathologic follow-up was assessed.
RESULTS: The UUT cytology specimens corresponded to 21 (40.4%) high-grade urothelial carcinoma (HGUC), 27 (51.9%) low-grade urothelial carcinoma (LGUC) and 4 (7.7%) benign cases on follow-up. For HGGC cases, the associated TPS categories included unsatisfactory (n = 1, 4.8%), negative for HGUC (NHGUC; n = 3, 14.3%), atypical urothelial cells (AUC; n = 6, 28.6%), suspicious for HGUC (SHGUC; n = 3, 14.3%) and HGUC (n = 8, 38.1%), while ORS categorised the specimens as unsatisfactory (n = 1, 4.8%), negative for malignant cells (NFMC; n = 3, 14.3%), AUC (n = 5, 23.8%), low-grade urothelial carcinoma (LGUC; n = 0, 0%), SHGUC (n = 5, 23.8%) and HGUC (n = 7, 33.3%). The risks of high-grade malignancy among cytologic categories were similar between ORS and TPS (p > 0.05). The majority of LGUC were classified as AUC similarly by ORS and TPS (55.6% vs. 59.3%).
CONCLUSIONS: Our
study demonstrated comparable performance between TPS 2.0 and ORS for UUT cytology specimens. Cytological diagnosis of UUT specimens remains challenging, especially for LGUC.