One year of experience using the Paris System for Reporting Urinary Cytology

• Published in: Cancer cytopathology Vol. 126; no. 6; pp. 430 - 436
• Main Authors: Meilleroux, Julie, Daniel, Gwendoline, Aziza, Jacqueline, d'Aure, Dominique M., Quintyn‐Ranty, Marie‐Laure, Basset, Céline ML, Evrard, Solène M., Courtade‐Saidi, Monique M.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-06-2018
• Subjects: Adult; Aged; Aged, 80 and over; Atypical Squamous Cells of the Cervix - pathology; atypical urothelial cells (AUC); Bladder cancer; Cellular biology; Cytodiagnosis - standards; Female; Follow-Up Studies; Histology; Humans; Male; Middle Aged; Prognosis; risk of malignancy; The Paris System for Reporting Urinary Cytology; Urinary Tract - pathology; Urine - cytology; Urologic Neoplasms - classification; Urologic Neoplasms - diagnosis; Urologic Neoplasms - urine; urothelial carcinoma; urothelial carcinoma; The Paris System for Reporting Urinary Cytology; atypical urothelial cells (AUC); urine cytology; risk of malignancy
• ISSN: 1934-662X; 1934-6638
• DOI: 10.1002/cncy.21999

BACKGROUND
The Paris System for Reporting Urinary Cytology (TPS) was published in November 2015. It focuses on the diagnosis of high‐grade urothelial carcinoma (HGUC) and provides criteria with which to define the category of atypical urothelial cells (AUC). The objective of the current study was to compare two 1‐year consecutive periods before and after use of TPS.
METHODS
A total of 1634 and 1814 urine cytology cases, respectively, were analyzed before and after use of TPS. Histological diagnosis within 6 months was available for 330 and 299 cases, respectively.
RESULTS
After use of TPS, the authors reported significantly fewer low‐grade urothelial neoplasms (0.94% vs 1.84%; P<.05) and more cases that were suspicious for HGUC (2.09% vs 0.73%; P<.01) compared with before use of TPS. For the AUC category, there was no significant change in frequency noted for before versus after TPS (6.12% vs 5.18%), whereas the rate of detection of HGUC on histology significantly increased after TPS when compared with before TPS (49.02% vs 28.17%; P<.02). For the HGUC category, neither the frequency (4.69% vs 4.47%) nor the risk of malignancy (89.39% vs 91.04% with HGUC on histology) were found to be significantly different when comparing before and after use of TPS.
CONCLUSIONS
In the authors' practice, TPS helped to better characterize the categories of AUC, low‐grade urothelial neoplasm, and suspicious for HGUC, which were associated with a higher risk of HGUC compared with the authors' previous classification. Cancer Cytopathol 2018;126:430‐6. © 2018 American Cancer Society.
The use of The Paris System for Reporting Urinary Cytology in the study laboratory has helped the authors to better characterize the categories of “atypical urothelial cells” and “suspicious for high‐grade urothelial carcinoma.” Herein, the authors report the risk of malignancy for the low‐grade, atypical, suspicious, and high‐grade categories.