Title: Evaluation of Urine Cytology in Urothelial Carcinoma with respect to the Paris System for Reporting Urinary Cytology
Authors: Soumitra Das, Anadi Roy Chowdhury, Supriya Basu
DOI: https://dx.doi.org/10.18535/jmscr/v5i11.111
Abstract
Objectives: This study aims to evaluate urine cytology as an investigational tool for urothelial carcinomas of urinary bladder in the light of the Paris System for reporting Urinary Cytology, the main goal being utilizing the diagnostic accuracy of this system in detection of high grade urothelial carcinoma.
Methods: A cross-sectional observational study was conducted over 1 year (August 2016- July 2017). The study population comprised patients presenting with haematuria and scheduled for trans-urethral resection of bladder tumour or radical cystectomy after a preliminary cystoscopy. Preoperative, early morning, midstream, voided urine samples were collected and processed. Reporting of urine cytology was done according to the Paris System. Results were correlated with gold standard test i.e. Histopathology. Test thresholds were selected for cytology and histopathology. Relevant statistical tests were utilized for data analysis.
Results: 72 cases were studied. According to the reporting criteria of the Paris System, 66.66% cases were positive for malignancy. 83.33 % of the positive and 75% of the negative cases were confirmed as such by histopathology. As per concordance between cytology and histopathology, the p value calculated was 0.0000571. The sensitivity of urine cytology was calculated to be 86.95%, the positive predictive value was 83.33%. The likelihood ratio of urine cytology as reported by the Paris system in diagnosing positive result in high grade carcinoma was calculated to be 2.82.
Conclusion: Urine Cytology as reported by the Paris System will lead to uniform and unequivocal reporting of urothelial carcinoma.
Keywords: Urine Cytology; Paris System; Urothelial Carcinoma.
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