A quest for accuracy: Evaluation of the Paris system in diagnosis of urothelial carcinomas

Rai, Sharada; Lali, Bhagat Singh; Venkataramana, Chaithra Gowthuvalli; Philipose, Cheryl Sarah; Rao, Ranjitha; Prabhu, Girish

doi:10.4103/joc.joc_67_18

Cited by 28 publications

(18 citation statements)

References 18 publications

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“…A systematic review of reports pertaining to TPS was performed with 27 studies included in the literature review (Table 3). 27–53 The studies which compared the cytology findings against tumor grade used the designation of “low” or “high” grade similar to WHO 2004. The cohort size was variable in each study (median: 149, range: 57 to 3900).…”

Section: Resultsmentioning

confidence: 99%

International Society of Urological Pathology (ISUP) Consensus Conference on Current Issues in Bladder Cancer. Working Group 1

Downes

Hartmann

Shen

et al. 2023

American Journal of Surgical Pathology

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Grade is a key prognostic factor in determining progression in nonmuscle invasive papillary urothelial carcinomas. The 2 most common grading methods in use worldwide are the World Health Organization (WHO) 2004 and 1973 schemes. The International Society of Urological Pathology (ISUP) organized the 2022 consensus conference in Basel, Switzerland on current issues in bladder cancer and tasked working group 1 to make recommendations for future iterations of bladder cancer grading. For this purpose, the ISUP developed in collaboration with the European Association of Urology a 10-question survey for their memberships to understand the current use of grading schemes by pathologists and urologists and to ascertain the areas of potential improvements. An additional survey was circulated to the ISUP membership for their opinion on interobserver variability in grading, reporting of urine cytology, and challenges encountered in grade assignment. Comprehensive literature reviews were performed on bladder cancer grading prognosis and interobserver variability along with The Paris System for urine cytology. There are notable differences in practice patterns between North American and European pathologists in terms of used grading scheme and diagnosis of papillary urothelial neoplasm of low malignant potential. Areas of common ground include difficulty in grade From the

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Section: Resultsmentioning

confidence: 99%

International Society of Urological Pathology (ISUP) Consensus Conference on Current Issues in Bladder Cancer. Working Group 1

Downes

Hartmann

Shen

et al. 2023

American Journal of Surgical Pathology

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“…An effective diagnostic algorithm has not been established for urinary cytology. Since 2016, TPS has been applied broadly and shows greater diagnostic accuracy than conventional cytology 7 . However, reports of false‐positives and ‐negatives emphasise the importance of further improvements in classification.…”

Section: Discussionmentioning

confidence: 99%

The inclusion of nuclear area improves the Paris system for reporting urinary cytology

et al. 2022

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Objective:The Paris System for Reporting Urinary Cytology (TPS) is a well-known urinary diagnostic model; however, occasional false-positives are a problem. To address this issue, we developed an improved algorithm (IA), based on additional cytological features, for TPS diagnosis.Methods: Cytological features were evaluated in 29 hard-to-classify cases, including 22 malignant cases and seven benign cases, using image analysis. The optimal IA was determined using the area under the receiver operating characteristic curve as an index. Re-evaluation was performed by applying measured values to the TPS and IA algorithms.Results: Using TPS, 12 of the 22 malignant cases were reassigned to a more appropriate category, and the remaining 10 malignant cases remained hard-to-classify. Two of the seven benign cases were classified as suspicious for high-grade urothelial carcinoma, and the remaining five benign cases remained in the original category. The IA, which included nuclear area as a parameter, showed the same diagnostic sensitivity as TPS, and three of the seven benign cases were reassessed as negative. Thus, the positive and negative predictive values of the IA were higher than those of TPS (84.6% and 100% vs 75.9% and 0%). Conclusions:The newly developed IA is a practical algorithm with which to address the limitations of TPS and thus may contribute to improved diagnostic accuracy.

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“…Conventional urine cytology has low sensitivity and subjective diagnostic criteria making it inadequate for diagnosing majority of lesions. [1][2][3][4] Hence, to overcome its pitfalls, at the 2013 International Congress of Cytology, The Paris System (TPS) working group proposed a system to categorise specimens into one of the seven categories: 1). Non diagnostic; 2).…”

Section: Introductionmentioning

confidence: 99%

Paris system of reporting urine cytology: An important screening tool for urothelial neoplasms

Rabha¹,

Devi

2023

JDPO

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Urine cytology is an important screening tool for detection of high grade urothelial carcinoma and follow-up of patients with treated disease. Ease of procurement, cost-effectiveness, and lower turnaround time are the major advantages of the system. We aim to determine the frequency of high grade and low grade urothelial carcinoma in urine cytology specimens and to evaluate the accuracy of Paris system. A retrospective study was conducted in the Department of Pathology (Cytology), GMCH from August 2020 to July 2022 where a total of 200 cases were included. Data along with the preserved slides of urine cytology of these cases were collected from the archives and examined for the presence of urothelial carcinoma. The results were calculated in Microsoft word and excel, and p value was calculated by using the Chi- square (χ2) test of significance, P values less than 0.05 was considered statistically significant. In our study, a total of 200 cases were analysed, 169 were males and 31 were females, the male to female ratio being 5.5: 1. The most commonly affected age group was 61-70 years, the mean age being 62 years. Of the 200 urine samples examined, 12.5% cases had High Grade Urothelial Carcinoma (HGUC), 13.5% cases had atypical urothelial cells, 9% cases were suspicious for HGUC and 2% cases had Low Grade Urothelial Neoplasm. : The Paris System is a highly sensitive and rapid tool for reporting urine cytology specimens and is particularly useful in diagnosing High Grade Urothelial Carcinoma thereby helping in early management of the patients with neoplastic lesions of the urinary bladder.

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A quest for accuracy: Evaluation of the Paris system in diagnosis of urothelial carcinomas

Cited by 28 publications

References 18 publications

International Society of Urological Pathology (ISUP) Consensus Conference on Current Issues in Bladder Cancer. Working Group 1

International Society of Urological Pathology (ISUP) Consensus Conference on Current Issues in Bladder Cancer. Working Group 1

The inclusion of nuclear area improves the Paris system for reporting urinary cytology

Paris system of reporting urine cytology: An important screening tool for urothelial neoplasms

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