Impact of Implementing the Paris System for Reporting Urine Cytology in the Performance of Urine Cytology: A Correlative Study of 124 Cases

Am J Clin Pathol. 2016 Sep;146(3):384-90. doi: 10.1093/ajcp/aqw127.

Abstract

Objectives: We assessed the performance of urine cytology using the Paris System for Reporting Urine Cytology (PSRUC) in comparison to our current system.

Methods: In total, 124 specimens with histologic correlation were reviewed and assigned to the PSRUC categories: benign, atypical urothelial cells (AUCs), suspicious for high-grade urothelial carcinoma (SHGUC), and high-grade urothelial carcinoma (HGUC). Original cytological diagnoses were recorded.

Results: Fewer cases were given an AUC diagnosis using the PSRUC in comparison to the original diagnoses (26% vs 39%), while the association of AUCs with subsequent HGUC increased from 33% to 53% with the PSRUC. Using the PSRUC resulted in a higher number of low-grade carcinomas assigned to the benign (40%) rather than the AUC (22%) category. The performance of SHGUC/HGUC diagnoses was similar in both systems (predictive value = 94%).

Conclusions: The PSRUC seems to improve the performance of urine cytology by limiting the AUC category to cases that are more strongly associated with HGUC.

Keywords: Atypical; Correlation; Cytology; High grade; Paris System for Reporting Urine Cytology; Performance; Urine.

MeSH terms

  • Aged
  • Carcinoma, Transitional Cell / diagnosis*
  • Carcinoma, Transitional Cell / pathology
  • Carcinoma, Transitional Cell / urine
  • Cytodiagnosis / methods*
  • Female
  • Humans
  • Male
  • Urinalysis / methods*
  • Urologic Neoplasms / diagnosis*
  • Urologic Neoplasms / pathology
  • Urologic Neoplasms / urine
  • Urothelium / pathology*