Evidence map›Paper›PMID 37627884›Full record

ArticleDiagnostics (Basel, Switzerland)2023

Diagnosis of Low-Grade Urothelial Neoplasm in the Era of the Second Edition of the Paris System for Reporting Urinary Cytology.

Konstantinos Christofidis, Napoleon Moulavasilis, Evangelos Fragkiadis, Dimitrios Goutas, Andreas C Lazaris, Dionisios Mitropoulos, Panagiota Mikou

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diagnostics (Basel, Switzerland), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Konstantinos ChristofidisCytopathology Department, Laiko General Hospital, 11527 Athens, Greece.ORCID 0000-0002-8074-8419
Napoleon Moulavasilis1st Urology Department, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece.ORCID 0000-0002-1820-9027
Evangelos Fragkiadis1st Urology Department, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece.
Dimitrios Goutas1st Laboratory of Pathology, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece.ORCID 0000-0003-1996-5884
Andreas C Lazaris1st Laboratory of Pathology, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece.ORCID 0000-0002-8118-7780
Dionisios Mitropoulos1st Urology Department, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece.
Panagiota MikouCytopathology Department, Laiko General Hospital, 11527 Athens, Greece.ORCID 0000-0002-8123-2676
National and Kapodistrian University of Athens · GRLaiko General Hospital of Athens · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Paris System for Reporting Urinary Cytology (TPS) is considered the gold standard when it comes to diagnostic classifications of urine specimens. Its second edition brought some important changes, including the abolition of the diagnostic category of "low-grade urothelial neoplasm (LGUN)", acknowledging the inability of cytology to reliably discern low-grade urothelial lesions.

methodsIn this retrospective study, we assessed the validity of this change, studying the cytological diagnoses of histologically diagnosed low-grade urothelial carcinomas during a three-year period. Moreover, we correlated the sum of the urinary cytology diagnoses of this period with the histological diagnoses, whenever available.

resultsAlthough all the cytological diagnoses of LGUN were concordant with the histological diagnoses, most low-grade urothelial carcinomas were misdiagnosed cytologically. Subsequently, the positive predictive value (PPV) of urinary cytology for the diagnosis of LGUN was 100%, while the sensitivity was only 21.7%. Following the cyto-histopathological correlation of the sum of the urinary cytology cases, the sensitivity of urinary cytology for the diagnosis of high-grade urothelial carcinoma (HGUC) was demonstrated to be 90.1%, the specificity 70.8%, the positive predictive value (PPV) 60.3%, the negative predictive value (NPV) 93.6% and the overall accuracy 77.2%, while for LGUN, the values were 21.7%, 97.2%, 87.5%, 58.6% and 61.9%, respectively. Risk of high-grade malignancy was 0% for the non-diagnostic (ND), 4.8% for the non-high-grade urothelial carcinoma (NHGUC), 33.3% for the atypical urothelial cells (AUCs), 65% for the suspicious for high-grade urothelial carcinoma (SHGUC), 100% for the HGUC and 12.5% for the LGUN diagnostic categories.

conclusionsThis study validates the incorporation of the LGUN in the NHGUC diagnostic category in the second edition of TPS. Moreover, it proves the ability of urinary cytology to safely diagnose HGUC and stresses the pivotal role of its diagnosis.

Indexed as

cyto-histopathological correlationlow-grade urothelial neoplasm (LGUN)non-high-grade urothelial carcinoma (NHGUC)TPSurinary cytology

Identifiers

PMID37627884
PMCPMC10453841
OpenAlexW4385654958

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.