Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Immunohistochemical Differentiation between Urothelial Papillomas and Papillary Neoplasms of Low Malignant Potential of the Urinary Bladder

  • Alrashidy, Mohammed (Department of Pathology, Faculty of Medicine, University of Tanta) ;
  • Atef, Aliaa (Department of Pathology, Faculty of Medicine, University of Tanta) ;
  • Baky, Tarek Abdel (Department of Urology, Faculty of Medicine, Menoufia University)
  • Published : 2016.06.01
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Abstract

Background: Urothelial papilloma and non-invasive papillary carcinoma are common neoplasms of the urinary bladder. Distinguishing papillomas and papillary carcinomas, especially the low grade type, is often debatable on the basis of histological features alone. Materials and Methods: We investigated immunohistochemical expression of cytokeratin 20 (CK20), p53, and Ki-67 in a group of 20 urothelial papilloma cases and 30 noninvasive papillary neoplasms of low malignant potential (PNLMP) of the urinary bladder. Whole tissue sections were examined. Results: Among the 30 carcinoma cases, 12 (40%) showed strong reactivity for the whole panel, 16 (53%) reacted positively for two markers, and 2 (7%) reacted just to one of them. Ki-67 was considered positive in 27 cases (90%) and p53 in 24 (80%), CK20 showed positive reactivity in 21 cases (70%). Only small percentages of papillomas were positive, and then only weakly. Conclusions: We concluded that the intense positivity of suspicious cells for at least one of these markers would confirm the presence of malignant changes and favours the diagnosis of carcinoma.

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References

  1. Alsheik A, Mohamedali Z, Jones E, et al (2001). Comparison of the WHO/ISUP classification and cytokeratin expression in predicting the behaviour of low-grade papillary urothelial tumors. Mod Pathol, 14, 267-72. https://doi.org/10.1038/modpathol.3880300
  2. Bertz S, Otto W, Denzinger S, et al (2014). Combination of CK20 and Ki-67 immunostaining analysis predicts recurrence, progression, and cancer-specific survival in pT1 urothelial bladder cancer. European Urol, 65, 218-26. https://doi.org/10.1016/j.eururo.2012.05.033
  3. Cheng L and Bostwick D (2011). Essentials of Anatomic Pathology. Pub. Springer Science and Business Media, 3rd ed., Ch. 36.
  4. Cina SJ, Lancaster-Weiss KJ, Lecksell K, et al (2001). Correlation of Ki67 and p53 with the new world health organization/international society of urological pathology classification system for urothelial neoplasia. Arch Pathol Lab Med, 125, 646-51.
  5. Eble J, Sauter G, Epstein J and Sesterhenn I (2004). World health organization classification of tumours. pathology and genetics of tumours of the urinary system and male genital organs. Pub. IARC Press Lyon, France, 90-110.
  6. Fletcher C (2013). Diagnostic histopathology of tumors. 4th ed., Pub. Elsevier Saunders, vol. 1, ch. 12, 610-11.
  7. Helpap B, Schmitz-drager B, Hamilton P, et al (2003): Molecular pathology of non-invasive urothelial carcinomas (part 1). Virchows Arch, 442, 309-16.
  8. Krause FS, Feil G, Bichler KH (2000): Immunohistochemical examinations (Ki67, p53, nm23) and DNA cytophotometry in bladder cancer. Anticancer Res, 20, 5023-8.
  9. Kumar V, Abbas A, Aster J (2015): Robbins and Cotran Pathologic Basis of Disease, 9th ed., Pub. Elseveir Saunders, ch. 21, 1028.
  10. Mallofre C, Castillo M, Morente V, Sole M (2003). Immunohistochemical expression of CK20, p53, and Ki- 67 as objective markers of urothelial dysplasia. Mod Pathol, 16, 187-91. https://doi.org/10.1097/01.MP.0000056628.38714.5D
  11. McKenney JK, Desai S, Cohen C, Amin MB (2001). Discriminatory immunohistochemical staining of urothelial carcinoma in situ and non-neoplastic urothelium: an analysis of cytokeratin 20, p53, and CD44 Antigens. Am J Surgical Pathol, 25, 1074-8. https://doi.org/10.1097/00000478-200108000-00013
  12. Mehta N, Rathore RS, Pillai BS, et al (2015). Intrinsic tumour factors affecting recurrence in non muscle invasive bladder cancer: a hospital based study from india. Asian Pac J Cancer Prev, 16, 2675-7. https://doi.org/10.7314/APJCP.2015.16.7.2675
  13. Mumtaz S, Hashmi AA, Hasan SH, et al (2014). Diagnostic utility of p53 and CK20 immunohistochemical expression grading urothelial malignancies. Int Arch Med, 7, 36. https://doi.org/10.1186/1755-7682-7-36
  14. Pich A, Chiusa L, Formiconi A, et al (2001). Biological differences between noninvasive papillary urothelial neoplasms of low malignant potential and low-grade (grade 1) papillary carcinomas of the bladder. Am J Surg Pathol, 25, 1528- 33. https://doi.org/10.1097/00000478-200112000-00009
  15. Tut VM, Braithwaite KL, Angus B, et al (2001). Cyclin D1 expression in transitional cell carcinoma of the bladder: correlation with p53, waf1, pRb and Ki67. Br J Cancer, 84, 270-5. https://doi.org/10.1054/bjoc.2000.1557
  16. Van Oers JM, Wild PJ, Burger M, et al (2007). FGFR3 Mutations and a Normal CK20 Staining Pattern Define Low-Grade Noninvasive Urothelial Bladder Tumours. European Urol, 52, 760-8. https://doi.org/10.1016/j.eururo.2007.01.009
  17. Yin H, Leong A (2004). Histologic grading of noninvasive papillary urothelial tumors. validation of the 1998 WHO/ ISUP system by immunophenotyping and Follow-up. Am J Clin Pathol, 121, 679-87. https://doi.org/10.1309/0KATYHQBJD5XHQ8J
  18. Zaher A, Sheridan T (2001). Tumor markers in the detection of recurrent transitional cell carcinoma of the bladder. Acta Cytol, 45, 575-81. https://doi.org/10.1159/000327867