Performance Characteristics of Urinary Tract Cytology: Observations From the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology

Barkan, Güliz A.; Laucirica, Rodolfo; Auger, Manon; Khalbuss, Walid E.; Padmanabhan, Vijyalakshmi; Souers, Rhona J.; Moriarty, Ann

doi:10.5858/arpa.2014-0227-cp

Cited by 12 publications

(8 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The authors postulated that the testing nature of the assignment may have psychologically biased the participants to select a positive (malignant/suspicious) diagnosis over a negative one. 2 In their analysis, similar to ours, a negative/benign-suspicious discrepancy carried the same weight as a negative/benign-positive discrepancy. It is also well known and previously shown that benign cases having many lymphoid cells or reactive mesothelial changes are often incorrectly interpreted as lymphoma or adenocarcinoma, respectively.…”

Section: Discussionsupporting

confidence: 75%

“…Those values were consistent with those obtained from the evaluation of CAP NGC program responses for urinary tract cytology samples. 2 In that study, the concordance rates for malignant and benign cases were 93.3% and 87.9%, respectively. The authors postulated that the testing nature of the assignment may have psychologically biased the participants to select a positive (malignant/suspicious) diagnosis over a negative one.…”

Section: Discussionmentioning

confidence: 76%

See 1 more Smart Citation

Performance Characteristics of Body Fluid Cytology Analysis of 344 380 Responses From the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology

Tabatabai

Nayar

Souers

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 76%

Performance Characteristics of Body Fluid Cytology Analysis of 344 380 Responses From the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology

Tabatabai

Nayar

Souers

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

View full text Add to dashboard Cite

show abstract

“…Like other nongynecologic cytology specimens, urinary tract specimens have been and still are processed using different methods, such as liquid‐based cytology methods (ThinPrep, SurePath), cytocentrifugation methods (Cytospin), filter methods, and conventional concentration and smearing techniques, which may result in some differences in the cellularity, morphology, and interpretation of these specimens …”

mentioning

confidence: 99%

“…Like other nongynecologic cytology specimens, urinary tract specimens have been and still are processed using different methods, such as liquid-based cytology methods (ThinPrep, SurePath), cytocentrifugation methods (Cytospin), filter methods, and conventional concentration and smearing techniques, which may result in some differences in the cellularity, morphology, and interpretation of these specimens. 10,11 In addition to or in lieu of cellularity, specimen volume may be used as indicator of adequacy for true exfoliative cytology specimens, such as cerebrospinal fluid, body fluids, and voided urine specimens. Similar to cellularity, specimen volume may be influenced by a multitude of factors, including patient-related factors, such as the level of hydration, micturition before specimen acquisition, the use of diuretics or other medications, the presence of obstructive conditions like benign prostatic hyperplasia, with consequent reduction of bladder capacity, and medical problems resulting in oliguria; and collection factors, such as the specimen container size, fractionation of the specimen because of aliquoting for various other tests, the addition of preservatives, leakage, etc.…”

mentioning

confidence: 99%

Enough is enough: Adequacy of voided urine cytology

Barkan

2015

Cancer Cytopathology

Self Cite

View full text Add to dashboard Cite

Sample adequacy is important in all areas of pathology but is an integral part of the report only for cytology samples, most likely because of the small nature of these specimens. The descriptor adequate is used essentially to deem that a specimen is representative of the sampled organ, site, or lesion. The initial (1988) Bethesda gynecologic cytology reporting system was the first to include a statement of adequacy as an essential part of a cytology report, 1 stating that cytopathologists should determine whether a specimen is adequate for diagnostic evaluation; and, if it is unsatisfactory or less than optimal, then it should be noted in the report. 1 Since then, adequacy has been used as a standard practice in other organ systems, such as thyroid 2 and pancreatic 3 cytopathology and endobronchial ultrasound-guided transbronchial fine-needle aspiration of mediastinal lymph nodes. 4,5 Most of the published proposed adequacy criteria are based on specimen cellularity. However, cellularity may not be an appropriate adequacy criterion for all cytologic specimens, because various parameters should be taken into account when judging the adequacy of a cytologic specimen, including: 1) the type of specimen (true exfoliative or forced exfoliative specimens, fine-needle aspiration specimens), 2) underlying condition, 3) processingrelated factors, and 4) operator-dependent and logistic factors. Urinary tract cytology is no exception; when determining the adequacy of such specimens, each of these 4 categories of factors must be considered. The specimen type is one of the most important factors affecting our judgement of adequacy. Although a true exfoliative specimen, such as cerebrospinal fluid, may be acellular but still adequate, a certain amount of cellularity is expected in a forced exfoliative specimen. For example, if a Pap test is acellular or has limited cellularity, it may be deemed inadequate using standardized, quantitative criteria established based on experimental studies. 6 Similarly, a forced exfoliative urinary tract specimen resulting from a bladder washing/barbotage or ureteral or urethral brushing is expected to have considerable cellularity. The exact amount of cells that would allow us to deem such a specimen adequate was first addressed by an evidencebased study from our institution. 7The patient's underlying condition or indication for cytologic evaluation may also affect the cellularity of urinary tract specimens and, consequently, our judgment of their adequacy. For instance, patients who were followed for urothelial carcinoma reportedly had a greater quantity of urothelial cells in their urinary tract specimens compared with patients who were worked up for hematuria or irritative voiding symptoms. 8,9 Because of decreased cell-to-cell adhesion, senescence, apoptosis, inflammation, or mechanical factors, patients with neoplasms, inflammatory/infectious conditions, and lithiasis involving the urinary tract may shed more cells in their voided urine specimens, but cellularity of their instrumented ur...

show abstract

“…The parameters surrounding adequacy in urinary cytology are cellularity and the volume of urine submitted for analysis; and, of these, there is very little evidence about the proper role of the volume in voided specimens resulting in a cellular specimen with high sensitivity and specificity. 5,6 The current development and impending release of the Paris System for Reporting Urinary Tract Specimens has created a critical demand for evidence-based criteria for determining adequacy in urinary tract specimens.…”

Section: Introductionmentioning

confidence: 99%

Adequacy in voided urine cytology specimens: The role of volume and a repeat void upon predictive values for high‐grade urothelial carcinoma

VandenBussche

Rosenthal

Olson

2015

Cancer Cytopathology

View full text Add to dashboard Cite

BACKGROUND: Adequacy assessment is one of the most controversial and overlooked components in the daily practice of cytopathology, because it is generally determined from limited samples. Because voided urine varies widely in terms of its volume and cellularity, there is little consensus about the proper role for these variables in assessing specimen adequacy. In this study, the authors explored the role of volume in voided urine specimens to determine whether it plays a role in determining adequacy for the detection of high-grade urothelial carcinoma. METHODS: Voided urine specimens received at the authors' laboratory over the 9.5 years since the introduction of the Johns Hopkins Template for Reporting Urinary Cytopathology were analyzed for correlations between volume, specimen adequacy, and the diagnosis of highgrade malignancy. The same data set also was queried to determine whether a patient who provided a voided lowvolume specimen could yield a higher volume specimen and thereby increase adequacy. RESULTS: In total, 15,731 voided urine specimens with a cumulative volume of 891 liters originating from 8594 individual patients were analyzed. Specimen adequacy increased linearly for each increment of volume submitted to the laboratory up to 30 mL, after which the correlation was nonlinear. Low-volume specimens below this cutoff also had lower fractions of specimens that were diagnosed as malignant or suspicious. CONCLUSIONS: Volume is an important component in the evaluation of adequacy for voided urine cytology specimens.

show abstract

Performance Characteristics of Urinary Tract Cytology: Observations From the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology

Abstract: Although the participants performed well in accurately classifying cases as benign and malignant, there were difficulties with the correct identification of adenocarcinoma and squamous cell carcinoma cases and with overinterpretation of ileal loop and Polyomavirus challenges as HGUC.

Cited by 12 publications

References 12 publications

Performance Characteristics of Body Fluid Cytology Analysis of 344 380 Responses From the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology

Performance Characteristics of Body Fluid Cytology Analysis of 344 380 Responses From the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology

Enough is enough: Adequacy of voided urine cytology

Adequacy in voided urine cytology specimens: The role of volume and a repeat void upon predictive values for high‐grade urothelial carcinoma

Contact Info

Product

Resources

About