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<0.0001). Conclusions: Discrete negative or benign urine cytology had the same sensitivity and specificity between two systems. Although atypical category associated with a higher ROM with the Hopkins template, the ROM for the suspicious category yielded better result with the Paris system.


中文翻译：

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约翰·霍普金斯模板的非典型类别具有比巴黎系统更高的 ROM，但巴黎系统更适用于可疑类别

简介：比较约翰·霍普金斯模板和巴黎尿细胞学报告系统之间的个别类别的性能。方法：从档案材料中获取膀胱活检患者的医疗记录和相关细胞学切片。幻灯片根据约翰·霍普金斯模板和巴黎模板重新分类。将结果与组织学诊断进行比较。结果：对 205 例活检随访病例（118 例良性、5 例不典型增生、23 例低度尿路上皮癌和 59 例恶性尿路上皮癌 (UC)）的 BD SurePath 制剂进行了审查。每个系统中有 2 个不合格的样本。根据约翰·霍普金斯模板，有 96 个（46.8%）无尿路上皮异型性或恶性肿瘤，37 个（18%）非典型尿路上皮细胞意义不明（AUC-US），21 个（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）和 11 例（5.4%）低级别尿路上皮癌（LGUC）。巴黎系统分类为 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 HGUC 可疑 (SHGUC)，36 例 (17.6%) HGUC 和 2 例 (1 %）LGUC。约翰·霍普金斯模板的敏感性为 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%。巴黎系统的敏感性为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%。约翰·霍普金斯模板中非典型类别 (AUC-US/AUC) 的恶性肿瘤风险 (ROM) 为 43.2%，而巴黎体系为 24.1%。可疑类别的ROM分别为47.6%和68.0%。每个系统中阴性和非典型、可疑和 HGUC 类别之间存在统计学显着差异 (p<0.0001)。结论：离散阴性或良性尿液细胞学检查在两个系统之间具有相同的敏感性和特异性。尽管非典型类别与霍普金斯模板的较高 ROM 相关，但可疑类别的 ROM 在巴黎系统中产生了更好的结果。