实施巴黎报告系统第一版的影响:系统性审查和元分析
Sahar J Farahani1, Joshua Li2, Beatrice Minder3
1Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Caner, New York, New York, USA.
概括
巴黎尿细胞学报告系统 (TPS) 标准化了诊断,减少了异常尿细胞 (AUC) 发现,并改善了高级恶性瘤 (HGM) 检测. 然而,负面结果并不排除HGM的存在.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 细胞病理学 细胞病理学
- 在瘤学瘤学.
背景情况:
- 尿细胞学对于诊断生殖尿路癌症至关重要,但缺乏标准化术语,限制了其临床实用性.
- 巴黎尿细胞学报告系统 (TPS) 是为了规范报告和提高高等级恶性瘤 (HGM) 的检测而开发的.
研究的目的:
- 系统地审查和元分析TPS对尿细胞学诊断性能和临床实用性的影响.
- 评估TPS采用后诊断类别分布和准确度指标的变化.
主要方法:
- 一项对英语研究 (2004年1月至2022年12月) 的系统综述和元分析,评估尿细胞学对生殖尿路恶性瘤的准确性.
- 包括64项研究 (99,796个样本),比较TPS和非TPS队列.
- 使用统计模型分析了诊断类别的相对分布,非典型的HGM比率,HGM风险 (ROHGM) 和HGM概率比率 (HGM-LR).
主要成果:
- 采用TPS显著增加了HGM (NHGUC) 诊断的负值,并降低了非典型泌尿道细胞 (AUC) 诊断.
- 与非TPS队列 (4.1) 相比,TPS队列 (2.0) 的AUC/HGM比率明显较低.
- TPS提高了可疑HGM (SHGUC) 和HGM类别的诊断实用性,用于识别高度病变.
结论:
- 巴黎尿细胞学报告系统 (TPS) 有效地减少了模两可的AUC诊断的频率,并改善了检测高度泌尿腺癌的能力.
- 虽然TPS增强了高度病变的识别,但负诊断 (NHGUC) 并不能完全排除高度恶性瘤的存在.
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