Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2020 Feb;128(2):119-125.
doi: 10.1002/cncy.22218. Epub 2019 Nov 27.

Split-sample comparison of urothelial cells in ThinPrep and cytospin preparations in urinary cytology: Do we need to adjust The Paris System for Reporting Urinary Cytology criteria?

Christopher J Richardson  1 , Stefan E Pambuccian  2 , Güliz A Barkan  2
Affiliations
Free article
Comparative Study

Split-sample comparison of urothelial cells in ThinPrep and cytospin preparations in urinary cytology: Do we need to adjust The Paris System for Reporting Urinary Cytology criteria?

Christopher J Richardson et al. Cancer Cytopathol. 2020 Feb.
Free article

Abstract

Background: The Paris System for Reporting Urinary Cytology (TPS) defines clear morphologic criteria to classify urinary specimens into 7 diagnostic categories. According to TPS, a nuclear-to-cytoplasmic ratio (N:C ratio) >0.7 and hyperchromasia must be observed to render a diagnosis of high-grade urothelial carcinoma (HGUC). TPS was established using only liquid-based preparation techniques, and to the authors' knowledge it is unknown whether TPS can be applied using other preparation methods.

Methods: In the current prospective study, voided urine samples from patients with HGUC and negative for HGUC (NHGUC) were prepared using both ThinPrep and cytospin methods. ImageJ image processing software was used to measure the N:C ratio and hyperchromasia. For each patient, the N:C ratio and degree of hyperchromasia of urothelial cells present in both cytopreparations were compared.

Results: A total of 10 HGUC cases and 9 NHGUC cases, represented by a total of 688 cells (mean, 36.7 cells in HGUC cases; and mean, 35.8 cells in NHGUC cases), were evaluated in the current study. An overall comparison of HGUC cells with NHGUC cells demonstrated that HGUC cells had a higher average N:C ratio (0.5465 vs 0.2846) and greater hyperchromasia as measured by the average nuclear pixel gray value (100.8 vs 120.7). The N:C ratio was statistically different in 4 NHGUC cases, demonstrating higher N:C ratios in the ThinPrep preparations. Hyperchromasia was found to be statistically different in 6 cases, 5 of which demonstrated increased hyperchromasia in the ThinPrep specimens.

Conclusions: The morphologic features of HGUC cells appear to be similar in samples prepared using the ThinPrep and cytospin methods, and therefore TPS criteria may be applied successfully in laboratories that use these methods.

Keywords: The Paris System for Reporting Urinary Cytology; hyperchromasia; nuclear-to-cytoplasmic (N:C) ratio; urinary cytology; urothelial carcinoma.

PubMed Disclaimer

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69:7-34.
    1. Barkan GA, Wojcik EM, Nayar R, et al. The Paris System for Reporting Urinary Cytology: the quest to develop a standardized terminology. J Am Soc Cytopathol. 2016;5:177-188.
    1. Pasin E, Josephson DY, Mitra AP, Cote RJ, Stein JP. Superficial bladder cancer: an update on etiology, molecular development, classification, and natural history. Rev Urol. 2008;10:31-43.
    1. Clark PE, Agarwal N, Biagioli MC, et al; National Comprehensive Cancer Network (NCCN). Bladder cancer. J Natl Compr Canc Netw. 2013;11:446-475.
    1. Rosenthal DL, Wojcik EM, Kurtycz DFI. The Paris System for Reporting Urinary Cytology. Springer Science+Business Media; 2015.

Publication types

MeSH terms

LinkOut - more resources