Matthew T. Olson
The Johns Hopkins University School of Medicine, USA
Title: The Paris system for reporting urinary cytology: Diagnostic paradigm shift, current topics, and the potential for molecular testing
Biography
Biography: Matthew T. Olson
Abstract
Urinary cytology has long been used as a first-step in the evaluation of a patient with a clinical suspicion for urothelial carcinoma (UC) as well as for surveillance of patients who have a known history of UC. Urinary cytology is most sensitive and specific in the diagnosis of high-grade carcinoma, which is also the tumor that is most likely to invade, metastasize, and cause mortality and morbidity for the patient. As such, the Paris System (TPS) for Reporting Cytopathology, which is an international consensus system developed with the backing of the International Academy of Cytology (IAC) and the American Society of Cytopathology (ASC), focuses on standardizing the reporting template worldwide and optimizing it for the detection of high grade UC. As such, TPS represents a major paradigm shift both because it is the first time urinary cytological reports are poised to have international uniformity and because it clearly outlines the appropriate place for how urinary cytology should be used and interpreted. This level of standardization should enable the deployment of molecular and other ancillary testing to targeted clinical problems in a manner that is most conducive to guiding patient care in a clinically relevant and cost-effective manner. Several strategies, including the existing technologies as well as a new gene expression classifier that is in development, will be discussed specifically in the context of TPS.