Utility of The Paris System for Reporting Urinary Cytology in patients with HPV-positive urinary tract carcinoma.

IF 2.6 3区 医学 Q3 ONCOLOGY Cancer Cytopathology Pub Date : 2024-10-15 DOI:10.1002/cncy.22914
Kara Tanaka, Neslihan Kayraklioglu, Emily Chan, Chien-Kuang C Ding, Poonam Vohra
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Abstract

Background: Human papillomavirus (HPV)-positive urinary tract carcinomas (UTCas) have distinct morphology and molecular features with potential treatment implications. Cytomorphologic analysis of these tumors on urine cytology specimens has not yet been reported. The authors evaluated the cytomorphologic findings of HPV-positive UTCa on urine cytology using The Paris System for Reporting Urinary Cytology (TPS) criteria.

Methods: HPV-positive cases were identified by a retrospective review of surgical specimens that had UTCa confirmed by HPV in situ hybridization. Cases that had concurrent urine cytology were reviewed using TPS. Cytomorphologic features of high-grade urothelial carcinoma (HGUC) were evaluated as well as the presence of atypical squamous cells (ASCs) and basaloid features.

Results: Sixteen cytology specimens from eight patients with HPV-positive UTCa were included. On original diagnosis, none of the cytology specimens were suggested to be HPV-associated. TPS diagnostic criteria identified eight cases with at least atypical findings, including five HGUC cases, one case that was suspicious for HGUC, and two atypical urothelial cases. Common cytomorphologic features included basaloid clusters (six of eight cases; 75%) and ASCs (four of eight cases; 50%) that matched the corresponding surgical specimens. Most cases exhibited urothelial cell hyperchromasia (seven of eight cases; 88%), and hypochromasia was a frequently observed variant (four of eight cases; 50%), either alone or in addition to hyperchromasia.

Conclusions: HPV-positive UTCa can be identified reliably as HGUC by using TPS criteria; however, these cases may not be recognized as HPV-associated. The presence of basaloid cells or ASCs can help suggest screening for HPV in urine specimens. Larger scale studies are warranted to validate cytomorphologic differences and determine the impact of HPV infection on clinical outcomes for patients with UTCa.

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巴黎尿液细胞学报告系统对 HPV 阳性尿路癌患者的实用性。
背景:人乳头瘤病毒(HPV)阳性尿路癌(UTCas)具有独特的形态和分子特征,对治疗有潜在影响。尿液细胞学标本上的细胞形态学分析尚未见报道。作者采用巴黎尿液细胞学报告系统(TPS)标准评估了尿液细胞学中 HPV 阳性 UTCa 的细胞形态学结果。使用 TPS 对同时进行尿液细胞学检查的病例进行复查。对高级别尿路上皮癌(HGUC)的细胞形态学特征以及非典型鳞状细胞(ASC)和基底细胞特征进行了评估:结果:共纳入了8名HPV阳性UTCa患者的16份细胞学标本。在最初诊断时,没有一份细胞学标本被认为与 HPV 相关。TPS诊断标准确定了8例至少有非典型发现的病例,包括5例HGUC病例、1例疑似HGUC病例和2例非典型尿路上皮病例。常见的细胞形态学特征包括基底簇(8 例中的 6 例;75%)和 ASCs(8 例中的 4 例;50%),与相应的手术标本相符。大多数病例表现为尿路细胞色素沉着(8 例中的 7 例;88%),低色素沉着是一种经常观察到的变异(8 例中的 4 例;50%),可单独存在或与色素沉着同时存在:结论:HPV 阳性 UTCa 可以通过 TPS 标准可靠地识别为 HGUC;但是,这些病例可能无法识别为 HPV 相关病例。基底细胞或ASCs的存在有助于建议对尿液标本进行HPV筛查。有必要进行更大规模的研究,以验证细胞形态学上的差异,并确定 HPV 感染对UTCa 患者临床预后的影响。
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来源期刊
Cancer Cytopathology
Cancer Cytopathology 医学-病理学
CiteScore
7.00
自引率
17.60%
发文量
130
审稿时长
1 months
期刊介绍: Cancer Cytopathology provides a unique forum for interaction and dissemination of original research and educational information relevant to the practice of cytopathology and its related oncologic disciplines. The journal strives to have a positive effect on cancer prevention, early detection, diagnosis, and cure by the publication of high-quality content. The mission of Cancer Cytopathology is to present and inform readers of new applications, technological advances, cutting-edge research, novel applications of molecular techniques, and relevant review articles related to cytopathology.
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