دورية أكاديمية
أعرض في EDS

Utility of the Paris System in Urine Cytology for Improved Screening of High-Grade Urothelial Carcinoma in Bahrain.

التفاصيل البيبلوغرافية
العنوان: Utility of the Paris System in Urine Cytology for Improved Screening of High-Grade Urothelial Carcinoma in Bahrain.
المؤلفون: Mahmoud Daoud R; Medicine, Royal College of Surgeons in Ireland (RCSI) - Bahrain, Busaiteen, BHR., Ali AH; Emergency Medicine, Salmaniya Medical Complex, Manama, BHR., Salim Fredericks S; Biochemistry, Royal College of Surgeons in Ireland (RCSI) - Bahrain, Busaiteen, BHR., Daoud S; General Practice, Albaraka Fertility Hospital, Manama, BHR., Gomaa HR; Orthopedics and Neurosurgery, Bahrain Defense Force Royal Medical Services, Riffa, BHR., AlHashimi FS; Pathology, King Hamad University Hospital, Busaiteen, BHR.
المصدر: Cureus [Cureus] 2024 Mar 29; Vol. 16 (3), pp. e57189. Date of Electronic Publication: 2024 Mar 29 (Print Publication: 2024).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Cureus, Inc Country of Publication: United States NLM ID: 101596737 Publication Model: eCollection Cited Medium: Print ISSN: 2168-8184 (Print) Linking ISSN: 21688184 NLM ISO Abbreviation: Cureus Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Palo Alto, CA : Cureus, Inc.
مستخلص: Background: Urothelial carcinoma, a prevalent and aggressive urological malignancy, necessitates early detection for improved prognosis. Urine cytology serves as a cost-effective screening tool, but inconsistencies in reporting due to the lack of standardized criteria limit its efficacy. The Paris System for reporting urinary cytology (TPS) was introduced to address this issue, aiming to improve diagnostic accuracy. This retrospective study investigates the effectiveness of urine cytology in detecting high-grade urothelial carcinoma (HGUC) using TPS classification, specifically focusing on atypical urothelial cells (AUC) categorized as TPS-III and suspicious for high-grade urothelial carcinoma (SHGUC) categorized as TPS-IV.
Methods: We reviewed 470 urine cytology samples collected over two years at a tertiary healthcare center in Bahrain. All samples were re-evaluated using TPS classification by two independent consultant cytopathologists blinded to the original cytology report. The analysis included only samples categorized as TPS-III or TPS-IV with corresponding histopathology reports from confirmatory biopsies performed within four months of urine collection. Biopsy results were categorized as either benign/low-grade urothelial carcinoma (non-HGUC) or malignant (HGUC). The positive predictive value (PPV) of urine cytology for HGUC detection was calculated for both TPS-III and TPS-IV categories. Statistical significance was assessed using Fisher's exact test.
Results: Among the 470 urine cytology samples, 40 (8.5%) were classified as TPS-III or TPS-IV. Within this subset, 16 patients underwent confirmatory biopsies. Histopathological analysis revealed HGUC in 12 (75%) patients and non-HGUC (benign or low-grade) in 4 (25%) patients. The PPV of TPS-III for HGUC was 50%, while TPS-IV demonstrated a higher PPV of 90%. However, the difference between these values was not statistically significant (p = 0.25). This study explored the utility of TPS classification in urine cytology for HGUC detection. While SHGUC (TPS-IV) exhibited a numerically higher PPV compared to AUC (TPS-III), the lack of statistical significance necessitates further investigation. Our findings highlight the potential of TPS to improve the accuracy of urine cytology. TPS implementation has been shown to reduce the number of inconclusive "atypical" diagnoses, leading to more targeted investigations.
Conclusion: Our study suggests that SHGUC (TPS-IV) within TPS classification framework might hold promise as a more specific indicator for HGUC compared to AUC (TPS-III). However, further research with larger cohorts is necessary to definitively establish the clinical significance of this observation. This investigation paves the way for future studies exploring the potential of TPS, particularly the SHGUC category, as a reliable screening tool for HGUC, potentially leading to earlier diagnoses and improved patient outcomes.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2024, Mahmoud Daoud et al.)
References: Cancer Cytopathol. 2018 Mar;126(3):207-214. (PMID: 29278461)
Eur Urol. 2003 Jun;43(6):632-6. (PMID: 12767364)
Cancer Cytopathol. 2013 Jul;121(7):387-91. (PMID: 23536358)
Eur Urol. 2000 Oct;38(4):419-25. (PMID: 11025380)
J Urol. 1973 Dec;110(6):664-6. (PMID: 4757548)
Diagn Cytopathol. 2021 Mar;49(3):367-373. (PMID: 33331144)
Cytojournal. 2019 Oct 22;16:21. (PMID: 31741668)
BMC Urol. 2022 Apr 5;22(1):51. (PMID: 35382830)
Am J Clin Pathol. 2016 Sep;146(3):384-90. (PMID: 27543983)
Cancer Cytopathol. 2018 Sep;126(9):809-816. (PMID: 30203925)
Cancer Cytopathol. 2021 Feb;129(2):156-163. (PMID: 33036060)
Am J Clin Pathol. 2009 Nov;132(5):785-93. (PMID: 19846822)
Cytojournal. 2017 Jul 24;14:17. (PMID: 28828030)
Acta Cytol. 2016;60(3):185-97. (PMID: 27318895)
Cureus. 2022 Nov 13;14(11):e31443. (PMID: 36523714)
Cytopathology. 2020 Jan;31(1):41-46. (PMID: 31654587)
فهرسة مساهمة: Keywords: cellular atypia; high-grade urothelial carcinoma; screening guidelines; the paris system for reporting urinary cytology; urothelial malignancy
تواريخ الأحداث: Date Created: 20240429 Latest Revision: 20240430
رمز التحديث: 20240430
مُعرف محوري في PubMed: PMC11056096
DOI: 10.7759/cureus.57189
PMID: 38681345
قاعدة البيانات: MEDLINE
الوصف
تدمد:2168-8184
DOI:10.7759/cureus.57189