Combined use of immunohistochemical markers of basal and luminal subtypes in urothelial carcinoma of the bladder: Association with clinicopathological features and outcomes
OBJECTIVES: Whole genome expression profiles allow the stratification of bladder urothelial carcinoma into basal and luminal subtypes which differ in histological patterns and clinical behavior. Morpho-molecular studies have resulted in the discovery of immunohistochemical markers that might enable discrimination between these two major phenotypes of urothelial carcinoma. METHODS: We used two combinations of immunohistochemical markers, i.e., cytokeratin (CK) 5 with CK20 and CK5 with GATA3, to distinguish subtypes, and investigated their association with clinicopathological features, presence of histological variants, and outcomes. Upon searching for tumor heterogeneity, we compared the findings of primary tumors with their matched lymph node metastases. We collected data from 183 patients who underwent cystectomy for high-grade muscle-invasive urothelial carcinoma, and representative areas from the tumors and from 76 lymph node metastasis were organized in tissue microarrays. RESULTS: Basal immunohistochemical subtype (CK5 positive and CK20 negative, or CK5 positive and GATA3 negative) was associated with the squamous variant. The luminal immunohistochemical subtype (CK5 negative and CK20 positive, or CK5 negative and GATA3 positive) was associated with micropapillary and plasmacytoid variants. Remarkably, only moderate agreement was found between the immunohistochemical subtypes identified in bladder tumors and their lymph node metastasis. No significant difference in survival was observed when using either combination of the markers. CONCLUSION: This study demonstrates that these three routinely used immunohistochemical markers could be used to stratify urothelial carcinomas of the bladder into basal and luminal subtypes, which are associated with several differences in clinicopathological features.
Main Authors: | , , , |
---|---|
Format: | Digital revista |
Language: | English |
Published: |
Faculdade de Medicina / USP
2021
|
Online Access: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100260 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
id |
oai:scielo:S1807-59322021000100260 |
---|---|
record_format |
ojs |
spelling |
oai:scielo:S1807-593220210001002602021-04-23Combined use of immunohistochemical markers of basal and luminal subtypes in urothelial carcinoma of the bladder: Association with clinicopathological features and outcomesRavanini,Juliana NavesAssato,Aline KawassakiWakamatsu,AldaAlves,Venâncio Avancini Ferreira Carcinoma Urinary Bladder Cystectomy Histologic Variants Tissue Microarray Immunohistochemistry OBJECTIVES: Whole genome expression profiles allow the stratification of bladder urothelial carcinoma into basal and luminal subtypes which differ in histological patterns and clinical behavior. Morpho-molecular studies have resulted in the discovery of immunohistochemical markers that might enable discrimination between these two major phenotypes of urothelial carcinoma. METHODS: We used two combinations of immunohistochemical markers, i.e., cytokeratin (CK) 5 with CK20 and CK5 with GATA3, to distinguish subtypes, and investigated their association with clinicopathological features, presence of histological variants, and outcomes. Upon searching for tumor heterogeneity, we compared the findings of primary tumors with their matched lymph node metastases. We collected data from 183 patients who underwent cystectomy for high-grade muscle-invasive urothelial carcinoma, and representative areas from the tumors and from 76 lymph node metastasis were organized in tissue microarrays. RESULTS: Basal immunohistochemical subtype (CK5 positive and CK20 negative, or CK5 positive and GATA3 negative) was associated with the squamous variant. The luminal immunohistochemical subtype (CK5 negative and CK20 positive, or CK5 negative and GATA3 positive) was associated with micropapillary and plasmacytoid variants. Remarkably, only moderate agreement was found between the immunohistochemical subtypes identified in bladder tumors and their lymph node metastasis. No significant difference in survival was observed when using either combination of the markers. CONCLUSION: This study demonstrates that these three routinely used immunohistochemical markers could be used to stratify urothelial carcinomas of the bladder into basal and luminal subtypes, which are associated with several differences in clinicopathological features.info:eu-repo/semantics/openAccessFaculdade de Medicina / USPClinics v.76 20212021-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100260en10.6061/clinics/2021/e2587 |
institution |
SCIELO |
collection |
OJS |
country |
Brasil |
countrycode |
BR |
component |
Revista |
access |
En linea |
databasecode |
rev-scielo-br |
tag |
revista |
region |
America del Sur |
libraryname |
SciELO |
language |
English |
format |
Digital |
author |
Ravanini,Juliana Naves Assato,Aline Kawassaki Wakamatsu,Alda Alves,Venâncio Avancini Ferreira |
spellingShingle |
Ravanini,Juliana Naves Assato,Aline Kawassaki Wakamatsu,Alda Alves,Venâncio Avancini Ferreira Combined use of immunohistochemical markers of basal and luminal subtypes in urothelial carcinoma of the bladder: Association with clinicopathological features and outcomes |
author_facet |
Ravanini,Juliana Naves Assato,Aline Kawassaki Wakamatsu,Alda Alves,Venâncio Avancini Ferreira |
author_sort |
Ravanini,Juliana Naves |
title |
Combined use of immunohistochemical markers of basal and luminal subtypes in urothelial carcinoma of the bladder: Association with clinicopathological features and outcomes |
title_short |
Combined use of immunohistochemical markers of basal and luminal subtypes in urothelial carcinoma of the bladder: Association with clinicopathological features and outcomes |
title_full |
Combined use of immunohistochemical markers of basal and luminal subtypes in urothelial carcinoma of the bladder: Association with clinicopathological features and outcomes |
title_fullStr |
Combined use of immunohistochemical markers of basal and luminal subtypes in urothelial carcinoma of the bladder: Association with clinicopathological features and outcomes |
title_full_unstemmed |
Combined use of immunohistochemical markers of basal and luminal subtypes in urothelial carcinoma of the bladder: Association with clinicopathological features and outcomes |
title_sort |
combined use of immunohistochemical markers of basal and luminal subtypes in urothelial carcinoma of the bladder: association with clinicopathological features and outcomes |
description |
OBJECTIVES: Whole genome expression profiles allow the stratification of bladder urothelial carcinoma into basal and luminal subtypes which differ in histological patterns and clinical behavior. Morpho-molecular studies have resulted in the discovery of immunohistochemical markers that might enable discrimination between these two major phenotypes of urothelial carcinoma. METHODS: We used two combinations of immunohistochemical markers, i.e., cytokeratin (CK) 5 with CK20 and CK5 with GATA3, to distinguish subtypes, and investigated their association with clinicopathological features, presence of histological variants, and outcomes. Upon searching for tumor heterogeneity, we compared the findings of primary tumors with their matched lymph node metastases. We collected data from 183 patients who underwent cystectomy for high-grade muscle-invasive urothelial carcinoma, and representative areas from the tumors and from 76 lymph node metastasis were organized in tissue microarrays. RESULTS: Basal immunohistochemical subtype (CK5 positive and CK20 negative, or CK5 positive and GATA3 negative) was associated with the squamous variant. The luminal immunohistochemical subtype (CK5 negative and CK20 positive, or CK5 negative and GATA3 positive) was associated with micropapillary and plasmacytoid variants. Remarkably, only moderate agreement was found between the immunohistochemical subtypes identified in bladder tumors and their lymph node metastasis. No significant difference in survival was observed when using either combination of the markers. CONCLUSION: This study demonstrates that these three routinely used immunohistochemical markers could be used to stratify urothelial carcinomas of the bladder into basal and luminal subtypes, which are associated with several differences in clinicopathological features. |
publisher |
Faculdade de Medicina / USP |
publishDate |
2021 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100260 |
work_keys_str_mv |
AT ravaninijuliananaves combineduseofimmunohistochemicalmarkersofbasalandluminalsubtypesinurothelialcarcinomaofthebladderassociationwithclinicopathologicalfeaturesandoutcomes AT assatoalinekawassaki combineduseofimmunohistochemicalmarkersofbasalandluminalsubtypesinurothelialcarcinomaofthebladderassociationwithclinicopathologicalfeaturesandoutcomes AT wakamatsualda combineduseofimmunohistochemicalmarkersofbasalandluminalsubtypesinurothelialcarcinomaofthebladderassociationwithclinicopathologicalfeaturesandoutcomes AT alvesvenancioavanciniferreira combineduseofimmunohistochemicalmarkersofbasalandluminalsubtypesinurothelialcarcinomaofthebladderassociationwithclinicopathologicalfeaturesandoutcomes |
_version_ |
1756432384260046848 |