PMID- 27508949
OWN - NLM
STAT- MEDLINE
DCOM- 20170531
LR  - 20170531
IS  - 1934-6638 (Electronic)
IS  - 1934-662X (Linking)
VI  - 124
IP  - 11
DP  - 2016 Nov
TI  - The positive predictive value of "suspicious for high-grade urothelial carcinoma" 
      in urinary tract cytology specimens: A single-institution study of 665 cases.
PG  - 811-819
LID - 10.1002/cncy.21764 [doi]
AB  - BACKGROUND: "The Paris System" proposes a 7-tier classification system for urine 
      cytology. Establishing the risk of malignancy (ROM) associated with these 
      diagnostic categories is essential to determine the appropriate management of 
      patients. The objective of this study was to determine the ROM associated with 
      the "positive" and "suspicious" categories. METHODS: The authors searched their 
      electronic records for urine cytology specimens that had been diagnosed as 
      "positive" or "suspicious" for high-grade urothelial carcinoma within an 11-year 
      time frame. Then, the ROM was determined for these specimens within a 6-month 
      follow-up interval. The cytologic diagnoses were correlated with surgical biopsy 
      results, follow-up cytology results, and/or fluorescence in situ hybridization 
      (FISH) results. RESULTS: In total, 662 specimens (487 "positive" and 175 
      "suspicious"), corresponding to 387 patients (295 men and 92 women), were 
      included. The majority of specimens were collected by bladder washing (568 of 662 
      specimens; 85.4%) and for the indication of surveillance (601 of 662 specimens; 
      82%). On follow-up, bladder washing specimens were positive more often positive 
      than voided urine specimens (466 of 570 [81.8%] vs 60 of 92 [65.2%]; P = .0005), 
      and surveillance specimens were more often positive than specimens collected for 
      other indications (82% vs 54.1%). The overall positive predictive value was 
      higher for positive specimens than for suspicious specimens (365 of 461 [79.2%] 
      vs 83 of 150 [55.3%]; P < .0001). CONCLUSIONS: Diagnoses of suspicious for 
      high-grade urothelial carcinoma, as used at the authors' institution, have an ROM 
      that is high but is lower than that for the "positive" category. Therefore, the 
      authors suggest keeping the 2 categories separate, although management should be 
      aggressive in both groups. Cancer Cytopathol 2016;124:811-9. (c) 2016 American 
      Cancer Society.
CI  - (c) 2016 American Cancer Society.
FAU - Joudi, Anthony M
AU  - Joudi AM
AD  - Department of Pathology, Loyola University Medical Center, Maywood, Illinois.
FAU - Pambuccian, Stefan E
AU  - Pambuccian SE
AD  - Department of Pathology, Loyola University Medical Center, Maywood, Illinois.
FAU - Wojcik, Eva M
AU  - Wojcik EM
AD  - Department of Pathology, Loyola University Medical Center, Maywood, Illinois.
FAU - Barkan, Guliz A
AU  - Barkan GA
AD  - Department of Pathology, Loyola University Medical Center, Maywood, Illinois.
LA  - eng
PT  - Journal Article
DEP - 20160810
PL  - United States
TA  - Cancer Cytopathol
JT  - Cancer cytopathology
JID - 101499453
SB  - IM
MH  - Carcinoma/*diagnosis/pathology
MH  - Cytodiagnosis/methods/standards
MH  - Female
MH  - Humans
MH  - In Situ Hybridization, Fluorescence/methods/standards
MH  - Male
MH  - Neoplasm Grading
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - Urethral Neoplasms/*diagnosis/pathology
OTO - NOTNLM
OT  - cytopathology
OT  - fluorescence in situ hybridization (FISH)
OT  - the Paris System
OT  - urinary cytology
OT  - urothelial carcinoma
EDAT- 2016/08/11 06:00
MHDA- 2017/06/01 06:00
CRDT- 2016/08/11 06:00
PHST- 2016/04/29 00:00 [received]
PHST- 2016/05/27 00:00 [revised]
PHST- 2016/06/02 00:00 [accepted]
PHST- 2016/08/11 06:00 [pubmed]
PHST- 2017/06/01 06:00 [medline]
PHST- 2016/08/11 06:00 [entrez]
AID - 10.1002/cncy.21764 [doi]
PST - ppublish
SO  - Cancer Cytopathol. 2016 Nov;124(11):811-819. doi: 10.1002/cncy.21764. Epub 2016 
      Aug 10.