The paris system for urine cytology: A 2 years' experience from Western Indian population

Abstract

Background and Aim: The Paris System (TPS) for Reporting Urine Cytology was introduced to bring uniformity in reporting urine cytology worldwide. The aim of this study is to assess the utility of TPS for Reporting Urine Cytology and correlate it with histopathology. Materials and Methods: This was a retrospective study, conducted at the cytology section of department of pathology. All the urine cytology samples received over a period of 2 years were retrieved and categorized as per TPS. The frequency of each TPS category along with relative risk for each category was calculated using the histopathological follow-up, wherever available. Results: A total of 200 urine cytology samples from 172 patients were categorized as per TPS. The most common category was negative for high grade urothelial carcinoma (UC) (61.5%; n = 123) followed by unsatisfactory for evaluation (15%; n = 30) and positive for high grade UC (HGUC) (10%; n = 20). There were 13 cases in category of suspicious for HGUC, 11 cases in atypical urothelial cell category, 2 cases in other malignancies, and one case in positive for low-grade UC. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for diagnosing HGUC on cytology according to TPS were 92.86%, 100%, 100%, 60%, and 85.29%, respectively. Conclusions: TPS has definitely helped us to categorize the urine cytology samples with the objective criteria and thus reducing unnecessary ambiguous diagnoses and ultimately directing the correct management of the patient.

Keywords

• diagnostic accuracy
• paris system
• risk of high grade malignancy
• sensitivity and specificity
• urine cytopathology
• urothelial carcinoma