Atypical category of the Johns Hopkins Template has higher ROM than the Paris System but the Paris system is more applicable for suspicious category
Atypical category of the Johns Hopkins Template has higher ROM than the Paris System but the Paris system is more applicable for suspicious category
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DOI：
10.1159/000529484
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发表时间：
2023-02-02
期刊：
影响因子：
1.8
通讯作者：
Kavas, Gamze
中科院分区：
文献类型：
--
作者：
Celik, Betul;Kavas, Gamze
简介：比较约翰霍普金斯模板和巴黎系统报告尿细胞学的个别类别的表现。方法：从档案资料中获取膀胱活检患者病历及相关细胞学切片。幻灯片根据约翰霍普金斯大学的模板和巴黎重新分类。结果与组织学诊断比较。结果：回顾了205例活检随访患者的BD SurePath制剂（118例良性，5例非典型增生，23例低恶性和59例恶性尿路上皮癌（UC））。每个系统有2个样本不足。根据Johns Hopkins模板，96例（46.8%）没有尿路上皮异型或恶性，37例（18%）不确定意义的非典型尿路上皮细胞（AUC-US）， 21例（10.2%）非典型尿路上皮细胞，不能排除HGUC (AUC-H)， 38例（18.5%）高级别尿路上皮癌（HGUC）， 11例（5.4%）低级别尿路上皮癌（LGUC）。Paris系统将111例（54.1%）为高级别尿路上皮癌阴性，29例（14.1%）为非典型尿路上皮细胞（AUC）， 25例（12.2%）为可疑HGUC (SHGUC)， 36例（17.6%）HGUC和2例（1%）LGUC。Johns Hopkins模板的敏感性为95.6%，特异性为73.6%，阳性预测值为61.5%，阴性预测值为96.3，总体诊断准确率为79.8%。Paris系统的敏感性为93.6%，特异性为77.9%，阳性预测值为65.6%，阴性预测值为96.5，总体诊断准确率为82.8%。在约翰霍普金斯模板中，非典型分类（AUC- us /AUC）的恶性肿瘤风险（ROM）为43.2%，而在巴黎系统中为24.1%。可疑类别的ROM分别为47.6%和68.0%。各系统中阴性与非典型、可疑和HGUC分类差异有统计学意义(p
Introduction: To compare performance of indivisual categories between the Johns Hopkins template and the Paris system for reporting urinary cytology.Methods: Medical records of patients with bladder biopsy and relevant cytology slides were obtained from archived material. Slides were reclassified according to Johns Hopkins Template and the Paris. Results were compared to histologic diagnoses.Results: BD SurePath preparations from 205 cases with biopsy follow up (118 benign, 5 dysplasia, 23 low-and 59 malignant urothelial carcinoma (UC)) were reviewed. There were 2 inadequate specimens in each system. According to the Johns Hopkins Template, there were 96 (46.8%) no urothelial atypia or malignancy, 37 (18%) atypical urothelial cells of uncertain significance (AUC-US), 21 (10.2%) atypical urothelial cells, cannot exclude HGUC (AUC-H), 38 (18.5%) high grade urothelial carcinoma (HGUC) , and 11 (5.4%) low grade urothelial carcinoma (LGUC). The Paris System categorized 111 (54.1%) negative for high grade urothelial carcinoma, 29 (14.1%) atypical urothelial cells (AUC), 25 (12.2%) suspicious for HGUC (SHGUC), 36 (17.6%) HGUC and 2 (1%) LGUC. The Johns Hopkins Template had a sensitivity of 95.6%, specificity of 73.6%, Positive Predictive Value of 61.5%, Negative Predictive Value of 96.3, with an overall diagnostic accuracy of 79.8%. The Paris System had a sensitivity of 93.6%, specificity of 77.9%, Positive Predictive Value of 65.6%, Negative Predictive Value of 96.5, with an overall diagnostic accuracy of 82.8%. The Risk of Malignancy (ROM) for atypical category (AUC-US/AUC) in the Johns Hopkins Template was 43.2%, while it has been 24.1% for the Paris System. The ROM for suspicious category was 47.6% and 68.0% respectively. There was a statistically significant differences between negative and atypical, suspicious, and HGUC categories in each system (p