Introduction: The aim of this study was to compare performance of individual 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 system. Results were compared to histological 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 high-grade urothelial carcinoma (HGUC), 38 (18.5%) 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 (AUCs), 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 were statistically significant differences between negative and atypical, suspicious, and HGUC categories in each system (p #x3c; 0.0001). Conclusions: Discrete negative or benign urine cytology had the same sensitivity and specificity between two systems. Although atypical category was associated with a higher ROM with the Hopkins template, the ROM for the suspicious category yielded better result with the Paris system.
Acta Cytologica

中文翻译：

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约翰霍普金斯模板的非典型分类比巴黎系统具有更高的恶性风险，但巴黎系统更适用于可疑类别

简介：本研究的目的是比较约翰霍普金斯大学模板和巴黎系统报告尿液细胞学的各个类别的表现。方法：从存档材料中获取膀胱活检患者的病历和相关细胞学切片。根据约翰霍普金斯模板和巴黎系统对载玻片进行重新分类。将结果与组织学诊断进行比较。结果：对来自 205 例活检随访病例（118 例良性、5 例异型增生、23 例低度尿路上皮癌 [UC] 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 个不合格样本。根据 Johns Hopkins 模板，有 96 例（46.8%）没有尿路上皮异型或恶性肿瘤，37 例（18%）非典型尿路上皮细胞意义不明（AUC-US），21 例（10.2%）非典型尿路上皮细胞，不能排除高-级尿路上皮癌 (HGUC)、38 例 (18.5%) HGUC 和 11 例 (5.4%) 低级别尿路上皮癌 (LGUC)。Paris 系统将 111 例 (54.1%) 高级别尿路上皮癌阴性、29 例 (14.1%) 非典型尿路上皮细胞 (AUC)、25 例 (12.2%) 可疑 HGUC (SHGUC)、36 例 (17.6%) HGUC 和 2 (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%。巴黎系统的灵敏度为 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%，而巴黎系统为 24.1%。可疑类别的 ROM 分别为 47.6% 和 68.0%。在每个系统中，阴性和非典型、可疑和 HGUC 类别之间存在统计学上的显着差异（p #x3c; 0.0001）。结论：离散阴性或良性尿细胞学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 Paris 系统中产生了更好的结果。
细胞学报