دورية أكاديمية

Clinical follow up and the impact of the Paris system in the assessment of patients with atypical urine cytology.

التفاصيل البيبلوغرافية
العنوان: Clinical follow up and the impact of the Paris system in the assessment of patients with atypical urine cytology.
المؤلفون: Northrup V; Deparment of Laboratory Medicine, Saint John Regional Hospital, Horizon Health Network, Saint John, New Brunswick, Canada.; Deparment of Research Services, Saint John Regional Hospital, Horizon Health Network, Saint John, New Brunswick, Canada., Acar BC; Deparment of Laboratory Medicine, Saint John Regional Hospital, Horizon Health Network, Saint John, New Brunswick, Canada.; Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada., Hossain M; Deparment of Laboratory Medicine, Saint John Regional Hospital, Horizon Health Network, Saint John, New Brunswick, Canada.; Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada., Acker MR; Deparment of Urology, Saint John Regional Hospital, Horizon Health Network, Saint John, New Brunswick, Canada.; Deparment of Urology, Dalhousie University, Halifax, Nova Scotia, Canada., Manuel E; Department of Medicine, Dalhousie Medicine New Brunswick, Saint John, Canada., Rahmeh T; Deparment of Laboratory Medicine, Saint John Regional Hospital, Horizon Health Network, Saint John, New Brunswick, Canada.; Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.
المصدر: Diagnostic cytopathology [Diagn Cytopathol] 2018 Dec; Vol. 46 (12), pp. 1022-1030. Date of Electronic Publication: 2018 Oct 30.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wiley-Liss Country of Publication: United States NLM ID: 8506895 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-0339 (Electronic) Linking ISSN: 10970339 NLM ISO Abbreviation: Diagn Cytopathol Subsets: MEDLINE
أسماء مطبوعة: Publication: New York Ny : Wiley-Liss
Original Publication: [New York, NY : Igaku-Shoin Medical Publishers, c1985-
مواضيع طبية MeSH: Urologic Neoplasms/*pathology , Urothelium/*pathology, Aged ; Carcinoma, Transitional Cell/pathology ; Cytodiagnosis/methods ; Epithelial Cells/pathology ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies
مستخلص: Background: Urinary cytology is routinely used in the diagnosis of urothelial neoplasms, with good sensitivity for high-grade urothelial carcinoma (HGUC) but less so for low-grade urothelial neoplasm (LGUN). There is significant interobserver and interinstitutional variability, especially for the atypical category. The Paris system for reporting urinary cytology (TPS) was introduced to better define the various categories, especially atypical cytology.
Methods: We retrospectively reviewed 630 atypia of undetermined significance (AUS) cases and reclassified them based on TPS. In total, 501 cases previously reported as negative for malignancy had their medical records reviewed to serve as negative controls.
Results: Of 630 AUS cases, 299 (47.5%) were reclassified as negative for HGUC (NHGUC), 313 (49.7%) as atypical urothelial cells (AUCs) and 18 (2.9%) as suspicious for HGUC (SHGUC). Based on our institution's previous reporting system, the rate of underlying or subsequent HGUC was 2.8% for AUS, and 0% for negative. When AUS cases were reclassified under TPS, the rates were 1.5% for NHGUC, 4.8% for AUC, and 0% for SHGUC. Review of medical records showed that patients with AUS were more likely to be followed-up compared with those with negative urine cytology (77.8% compared with 54.3%), particularly those under the care of non-urologists.
Conclusions: AUS diagnosis is associated with more patient follow up compared with NEG urine particularly among non-urologists. Reclassifying according to TPS results in significant reduction in the rate of AUS and thus unnecessary testing. This reduction however may be at the expense of slightly decreased detection rate of HGUC.
(© 2018 Wiley Periodicals, Inc.)
فهرسة مساهمة: Keywords: Paris system; atypia; urinary cytology; urothelial carcinoma
تواريخ الأحداث: Date Created: 20181031 Date Completed: 20190405 Latest Revision: 20190405
رمز التحديث: 20240628
DOI: 10.1002/dc.24095
PMID: 30375194
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-0339
DOI:10.1002/dc.24095