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Figure legends
Figure 1. Traced high-grade urothelial carcinoma cell nucleus on the ImageJ application
window (Papanicolaou stain, original magnification × 100).
Figure 2. (a) Reactive renal tubular cells (RRTCs). (b) Reactive urothelial cells (RUCs).
(c) High-grade urothelial carcinoma (HGUC) cells (Papanicolaou stain, original
magnification ×100).
Figure 3. Comparison of cytomorphologic features in each disease group.
*HGUC: high-grade urothelial carcinoma, RRTCs: reactive renal tubular cells, RUCs:
reactive urothelial cells
Figure 4. ROC curve analysis of cytomorphologic features to detect HGUC cells.
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*AUC: area under the curve, ROC: receiver operating characteristic, HGUC: high-grade
urothelial carcinoma
Author contributions
Methodology: Ohsaki H. Formal analysis: Sakumo K., Morihashi K., Nakamura A. and
Ohsaki H. Software: Sakumo K. and Nakamura A. Visualization: Sakumo K. and Ohsaki
H. Resources: Nukaya T., Sumitomo M., Sofue T., Haba R., Itoh T., and Ohsaki H.
Writing-original draft: Ohsaki H. Writing-review and editing: Sakumo K., Nakamura
A., Nakamura M, Kamoshida S. and Ohsaki H. Supervision: Ohsaki H
Data availability statement
Data supporting the findings of this study are available from the corresponding author
upon reasonable request.
Inside this month's Cytopathology
Nuclear-to-cytoplasmic ratio is considered the most important cytomorphological feature
in The Paris System for reporting urine cytology. However, evaluation of other
cytomorphological features is lacking. This study compared various cytomorphological
features of high-grade urothelial carcinoma cells and benign reactive cells using a digital
23
image analyser. Quantitative analysis revealed the usefulness of the nuclear area, which
has not been reported until now.
24
Figure 1. Traced high-grade urothelial carcinoma cell nucleus on the ImageJ application window
(Papanicolaou stain, original magnification × 100).
Figure 2. (a) Reactive renal tubular cells (RRTCs)(Papanicolaou stain, original magnification ×100).
Figure 2. (b) Reactive urothelial cells (RUCs). (Papanicolaou stain, original magnification ×100).
Figure 2. (c) High-grade urothelial carcinoma (HGUC) cells. (Papanicolaou stain, original magnification ×100).
Figure 3. Comparison of cytomorphologic features in each disease group.
*HGUC: high-grade urothelial carcinoma, RRTCs: reactive renal tubular cells, RUCs: reactive urothelial cells
Figure 4. ROC curve analysis of cytomorphologic features to detect HGUC cells.
*AUC: area under the curve, ROC: receiver operating characteristic, HGUC: high-grade urothelial carcinoma
Table 1. Comparison of cytomorphological criteria to distinguish between HGUC cells and benign atypical cells
HGUC
cells
BRCs
AUC
SE
All cells
Nuclear area
Cell area
N: C ratio
Nuclear roundness
1180
1180
1180
1180
1687
1687
1687
1687
0.920
0.781
0.849
0.624
Top five cells
Nuclear area
Cell area
N: C ratio
Nuclear roundness
75
75
75
75
265
265
265
265
0.992
0.920
0.977
0.605
Youden index maximum / PPV 100%
Cut off value
Sensitivity
Specificity
0.005
0.009
0.007
0.011
98.8 / 253.9
229.7 / 613.9
0.438 / 0.702
0.928 / 0.963
0.887 / 0.159
0.733 / 0.079
0.829 / 0.075
0.302 / 0.004
0.795 / 1.000
0.671 / 1.000
0.699 / 1.000
0.900 / 1.000
0.003
0.018
0.008
0.042
169.6 / 236.6
424.9 / 572.1
0.619 / 0.698
0.785 / 0.680
0.960 / 0.747
0.800 / 0.493
0.920 / 0.693
0.493 / 0.107
0.951 / 1.000
0.909 / 1.000
0.951 / 1.000
0.762 / 1.000
*HGUC: high-grade urothelial carcinoma, BRCs: benign reactive cells, AUC: area under the curve, SE: standard error,
PPV: positive predictive value
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