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Digital image analysis supports a nuclear‐to‐cytoplasmic ratio cutoff value below 0.7 for positive for high‐grade urothelial carcinoma and suspicious for high‐grade urothelial carcinoma in urine cytology specimens

Urinary cytology is sensitive and specific for diagnosing and screening high‐grade urothelial carcinomas (HGUC). The Paris System (TPS) for urinary cytology was introduced in 2016 to standardize reporting. According to TPS diagnostic categories of HGUC and suspicious for HGUC (SHGUC), the average nuclear‐to‐cytoplasm (N:C) ratio of atypical cells should be ≥0.7. The objective of the current study was to measure the N:C ratio of urine cytology specimens with HGUC and SHGUC diagnoses and biopsy‐proven HGUC follow‐up.