Clinical utility and concordance of upper urinary tract cytology and biopsy in predicting clinicopathological features of upper urinary tract urothelial carcinoma

Abstract

Clinical utility and concordance of upper urinary tract cytology and biopsy in predicting Clinicopathologic features of upper urinary tract urothelial carcinoma. Human Pathology.

A review of upper urinary tract cytology performance before and after the implementation of The Paris System

“…The reported sensitivities of UUT cytology for HGUC after implementation of TPS ranged from 19% to 82% while maintaining relatively high specificities ranging from 86% to 100% and positive predictive values ranging from 92% to 100% (Table 5). 54‐59 These findings are not markedly different from the meta‐analysis of pre‐TPS literature as mentioned above, which showed an overall sensitivity of 53% (range, 21%‐77%) and specificity of 90% (range, 77%‐97%) for the detection of UTUC in UUT cytology 44 …”

“…Among them, the reported rates of negative for HGUC (NHGUC), atypical urothelial cells (AUC), SHGUC, and HGUC ranged from 0% to 39%, 13% to 37%, 10% to 36%, and 16% to 62%, respectively (Table 3). 14,48,54‐59 …”

“…The overall sensitivity for LGUN is much lower than that for HGUC. The reported sensitivities of UUT cytology for LGUC prior to TPS was 46%, 44 and ranged from 0% to 34% (average 17%) after implementation of TPS 14,54‐59 …”

“…Among them, the reported rates of negative for HGUC (NHGUC), atypical urothelial cells (AUC), SHGUC, and HGUC ranged from 0% to 39%, 13% to 37%, 10% to 36%, and 16% to 62%, respectively (Table 3). 14,48,[54][55][56][57][58][59] However, only 3 studies compared the frequency of comparable diagnostic categories pre-and post-TPS. 54,56,57 In these studies, pre-TPS cases with previously rendered final diagnoses were re-reviewed and reclassified using TPS criteria.…”

“…The reported sensitivities of UUT cytology for LGUC prior to TPS was 46%, 44 and ranged from 0% to 34% (average 17%) after implementation of TPS. 14,[54][55][56][57][58][59] The instrumentation required to procure UUT cytology specimens can result in the exfoliation of benign, reactive urothelial tissue fragments along with fragments of neoplastic cells. This complicates the detection of LGUN, as LGUN tissue fragments can have significant cytomorphologic overlap with tissue fragments containing benign and reactive urothelial cells.…”