Accuracy of Paris 2016 System for Non-invasive Diagnosis Bladder Malignancy

Abstract

Scan to discover onlineBackground & Objective: The Paris System for Reporting Urinary Cytology (TPS) is a new method for evaluating urinary cytology designed to reduce unreproducible reports. The aim of this study was to reclassify and compare urinary cytology reports with TPS criteria to determine the frequency of unreproducible reports compared to the previous system.Methods: In this study, the laboratory electronic registration system analyzed patients' urine samples taken by voided or washing and brushing methods. The cytological evaluation was performed considering the previous system and TPS by a pathologist. The results of the two systems were compared, and the sensitivity and specificity of TPS were calculated.Results: Urine samples were taken from 876 patients. The mean age of patients was 63.36 ± 12.62. Comparing the routine classification system and TPS, it was observed that the number of atypical reports in the TPS system decreased by 12%, and all of these cases were downgraded to the negative group in the new classification. The sensitivity and specificity of TPS were 29.4% and 95.1%, respectively, if suspected malignancy and positive reports for malignancy were considered. Finally, if positive reports for malignancy were selected, sensitivity and specificity changed to 11.8% and 100%, respectively.Conclusion: Although the TPS system has low sensitivity for the diagnosis of urothelial malignancies, due to its high specificity, it is possible to consider and use this classification for screening patients.

Are we on track for diagnosing high‐grade urothelial carcinoma with a minimum quantity of five malignant cells in lower tract specimens? Critical analysis of The Paris System Quantitation Criteria

“…Our findings further validate that at least five HGCs quantitation requirements per the TPS. More so, the strict application of TPS understandably comes with a low‐to‐moderate sensitivity value (38%–56%) as reported in studies analyzing the impact of TPS, with specificity (97%–100%), PPV (93%–100%), and a NPV as high as 90% 21–24 . We used ThinPrep, and studies have shown that the use of the liquid‐based preparations is reliable, with high ROHM and high concordance among interpreters in detecting HGUC by application of TPS in lower urinary; the rate of detection of HGUC is not affected by the method of specimen collection (voided or collected by bladder washings) 10,20,25,26 …”

“…More so, the strict application of TPS understandably comes with a low-to-moderate sensitivity value (38%-56%) as reported in studies analyzing the impact of TPS, with specificity (97%-100%), PPV (93%-100%), and a NPV as high as 90%. [21][22][23][24] We used ThinPrep, and studies have shown that the use of the liquidbased preparations is reliable, with high ROHM and high concordance among interpreters in detecting HGUC by application of TPS in lower urinary; the rate of detection of HGUC is not affected by the method of specimen collection (voided or collected by bladder washings). 10,20,25,26 Following review of the 36 cases of HGUC (from 22 patients) with negative histology (Cohort 2) on concurrent biopsy, we found all cases meeting the criteria for diagnosing HGUC in lower urinary tract specimens as outlined by TPS.…”