title: The application of the Johns Hopkins Hospital Template on urine cytology.
abstract: BACKGROUND
  To evaluate the utility of the Johns Hopkins Hospital (JHH) template in detection of high-grade urothelial carcinoma (HGUC).
  
  
  METHODS
  A computerized search of our laboratory information system was performed for all urine cytology cases from 2009 to 2011 processed by the SurePath™. We included only cases with correlating surgical pathology within 6 months after the urinary samples were obtained. The original cytologic diagnoses were reclassified according to the JHH template, and these cytolog ic diagnoses were then correlated with the follow-up surgical pathology diagnoses.
  
  
  RESULTS
  A total of 273 urine samples with histopathologic follow-up were identified. The reclassified cytologic diagnoses included negative for urothelial atypia or malignancy (NUAM) 110; atypical urothelial cells of undetermined significance (AUC-US) 83; atypical urothelial cells, cannot exclude high-grade urothelial carcinoma (AUC-H) 49; HGUC 29; and low-grade urothelial carcinoma (LGUC) 2. More than one-half of patients (58%) who had biopsy-confirmed high-grade urothelial lesions had a preceding cytologic diagnosis of AUC-H or HGUC. AUC-H and HGUC are associated with high-grade urothelial lesions in 80% and 90% of the cases and show statistical significance when compared with AUC-US or NUAM (P < 0.05).
  
  
  CONCLUSIONS
  The JHH template is useful and effective in identifying patients with high-grade urothelial lesions who need to undergo cystoscopy.
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Howard H
authors.initials: HH
authors.lastname: Wu
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Megan
authors.initials: M
authors.lastname: Redelman
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Shaoxiong
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: David J
authors.initials: DJ
authors.lastname: Grignon
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Harvey M
authors.initials: HM
authors.lastname: Cramer
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003581:Cytodiagnosis / Q000379:methods*; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D016482:Urinalysis / Q000379:methods*; D014571:Urologic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D019459:Urothelium / Q000473:pathology*; D055815:Young Adult
keywords: Johns Hopkins Hospital template; SurePath; cytology; urine; urothelial carcinoma