Evaluation of the Paris System in atypical urinary cytology

Cytopathology. 2018 Dec;29(6):545-549. doi: 10.1111/cyt.12585. Epub 2018 Aug 1.

Abstract

Objective: Our aim was to evaluate the Paris System for reporting urinary cytology, especially in the field of atypia.

Methods: During the last year, 104 urinary cases had atypical cytology. These cases were reviewed and reclassified by three cytopathologists using the Paris criteria. Cyto-histological correlation was performed in 47 cases. Additionally, all cytology diagnoses were correlated with double immunocytochemistry for p53 and CK20 result. Interobserver consistency was also evaluated.

Results: Out of 104 atypical cases, 30 were classified as benign, 49 atypical and 25 suspicious for high-grade urothelial carcinoma (HGUC). Diagnostic consistency between the three observers reached 93.27%. Using the new criteria, only 47.1% of the cases remained in the atypical category. The rate of HGUC histology was 14.3%, 26.7% and 96% in the benign, atypical and suspicious for HGUC cytological categories, respectively. Immunocytochemistry positivity was observed in 25.9%, 41.8% and 80% of the cases in the three diagnostic groups.

Conclusions: The Paris System for reporting urinary cytology provides clear, easy to adopt criteria, which lead to diagnostic categories with clinical significance, facilitating patient management decisions.

Keywords: cancer; classification; cytology; immunocytochemistry; urine.

MeSH terms

  • Carcinoma, Transitional Cell / diagnosis
  • Carcinoma, Transitional Cell / pathology
  • Cytodiagnosis / methods
  • Epithelial Cells / cytology
  • Epithelial Cells / pathology
  • Female
  • Humans
  • Immunohistochemistry / methods
  • Male
  • Middle Aged
  • Urinary Bladder Neoplasms / diagnosis
  • Urinary Bladder Neoplasms / pathology
  • Urinary Tract / cytology*
  • Urinary Tract / pathology*
  • Urologic Neoplasms / diagnosis
  • Urologic Neoplasms / pathology
  • Urothelium / cytology*
  • Urothelium / pathology