Our New Study Highlights the Impact of the Paris System for Reporting Urine Cytology on Diagnostic Performance

Jun 28
Our recent systematic review and meta-analysis published at the Journal of Cytopathology, evaluated the effects of the Paris System for Reporting Urine Cytology (TPS) on improving diagnostic performance and clinical utility. Urine cytology, a noninvasive tool used for screening genitourinary tract neoplasms, has faced challenges due to the lack of standardized terminology and clear morphological criteria.

The study, which searched six electronic databases, included 64 studies comprising a total of 99,796 urine cytology samples from January 2004 to December 2022. Researchers compared the diagnostic accuracy between TPS and non-TPS cohorts to assess the impact of TPS implementation.

Key findings include:
  • The adoption of TPS led to an increased frequency of negative for high-grade urothelial carcinoma (NHGUC) diagnoses and a reduction in atypical urothelial cells (AUC) diagnoses.
  • The ratio of atypical to high-grade malignancy (AUC/HGM) significantly decreased in the TPS cohort, indicating more precise diagnoses.
  • The frequency of low-grade urothelial neoplasms (LGUN) diagnosed as AUC also significantly decreased in the TPS cohort compared to non-TPS cohorts.
  • The study found that TPS improved the clinical utility of suspicious for high-grade urothelial carcinoma (SHGUC) and HGM diagnoses in detecting high-grade lesions.
Despite these improvements, the study noted that an NHGUC diagnosis still does not reliably rule out the presence of a high-grade lesion, indicating a need for continued refinement in urine cytology reporting.

The findings underscore the importance of standardized reporting systems like TPS in enhancing diagnostic accuracy and clinical outcomes for patients under surveillance for genitourinary malignancies.