Implementation of the Paris system versus institutional diagnosis in the performance of urinary cytology: A 5 years correlative study of 74 cases

Abstract

Introduction: Urine cytology used for diagnosing high-grade urothelial carcinoma (HGUC), but plagued by low sensitivity and wide inter-observer variability mainly ascribed to the lack of an established template of reporting. We assessed the performance of urine cytology by comparing the Paris System with our current institutional system. This study is developed to identify the prevalence of various cytological categories and their association with a subsequent diagnosis of high-grade urothelial carcinoma. Materials and Methods: A total of seventy four urine cytological specimens were studied which have follow up biopsy with histological correlation was done to categorize: benign, atypical urothelial cells (AUCs), suspicious for high-grade urothelial carcinoma (SHGUC), and high-grade urothelial carcinoma (HGUC). Original cytological diagnoses were recorded. Results: Males outnumbered females with a mean age of 57.4 years (range 21-86) (46 M and 28 F) with no statistical significance among the age groups and between male and female genders. By applying TPS, number of cases assigned to AUC category are very few (7 cases out of 74 with 9.45. Using the TPS resulted in a higher number of low-grade carcinomas assigned to the benign rather than the AUC category. LGUN category includes all low grade urothelial neoplasms of urinary tract, such as LGUC and PUN of uncertain malignant potential. According to institute diagnosis categories for urine cytology, there were 2 cases shown negatives, 16 cases shown Atypical/suspicious, 21 cases shown LG papillomas, and 35 cases shown HGUC. In negative group; out of 2 cases, 2 cases were papilloma. In HGUC group, out of 35 cases, 27 cases were turned out to be HGUC with 77.14%. In HGUC group, out of 35 cases, 8 cases were turned out to be LGUP with 29.62%. Conclusion: The TPS seems to improve the performance of urine cytology by limiting the AUC category to cases that are more strongly associated with HGUC. This is the first inclusive a