Atypical urine cytology and the Johns Hopkins Hospital template: The University of Chicago experience

Elizabeth Morency*, Tatjana Antic

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Introduction: The rate of atypical diagnoses in urine cytology can be high depending on the screening population. Unlike thyroid and cervical cytology, there is a lack of standardized criteria to stratify them into more clinically meaningful categories. Materials and methods: A set of diagnostic criteria described by Johns Hopkins Hospital (JHH) provided a tool to divide atypical urine specimens into those that were low risk and those likely to be predictive of high-grade urothelial carcinoma (HGUC). In this study, the JHH template was applied to a cohort of atypical urine cytology specimens from the University of Chicago (U of C) to compare it to existing U of C terminology and determine whether it should be formally adopted. Results: Sixty-eight percent of patients classified as atypical urothelial cells, favor high-grade lesion (AUC-H) were diagnosed with HGUC during the study. Correlation was noted between the JHH diagnostic categories and the U of C diagnostic categories, with 49% of patients reclassified as AUC-H being diagnosed with atypical urothelial cells, suspicious for neoplasia and 83% of cases of patients reclassified as atypical urothelial cells of unknown significance being diagnosed as atypical, urothelial cells. The JHH category of AUC-H had a higher positive predictive value for HGUC than the U of C category atypical urothelial cells, suspicious for neoplasm did (69% versus 58%, p = 0.0087). Unlike the JHH study, AUC-H showed higher correlation with HGUC in the hematuria group (90%) than in the surveillance group (66%). Conclusions: JHH criteria demonstrated a higher rate of predicting HGUC than U of C diagnostic categories, supporting the adoption of these criteria at U of C.

Original languageEnglish (US)
Pages (from-to)295-302
Number of pages8
JournalJournal of the American Society of Cytopathology
Volume3
Issue number6
DOIs
StatePublished - Nov 1 2014

Keywords

  • Atypia
  • High-grade urothelial carcinoma
  • JHH template
  • Screening
  • URINE cytology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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