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Hum Pathol. 2014 Jul;45(7):1473-82. doi: 10.1016/j.humpath.2014.02.024. Epub 2014 Mar 14.

Immunohistochemical evaluation of novel and traditional markers associated with urothelial differentiation in a spectrum of variants of urothelial carcinoma of the urinary bladder.

Author information

1
Departments of Pathology and Surgery, Section of Urology, University of Chicago, Chicago, IL 60637, USA.
2
Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
3
Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Department of Pathology, Beaumont Hospital, Dublin, Ireland.
4
Department of Pathology, MD Anderson Cancer Center, Houston, TX 77030, USA.
5
Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, TX 77030, USA.
6
Department of Pathology, University of California at San Diego, La Jolla, CA 92093, USA.
7
Unit of Anatomic Pathology, Faculty of Medicine, Cordoba University, Cordoba, Spain.
8
University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
9
Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. Electronic address: aminm@cshs.org.

Abstract

Data on immunohistochemical expression of novel and traditional urothelial markers in the wide range of urothelial carcinoma variants have so far been very limited. In this study, whole tissue sections from 130 bladder urothelial carcinoma and variants were stained with a panel of novel and traditional immunomarkers supportive of urothelial lineage. The positivity rates were as follows: (a) urothelial carcinomas with or without divergent differentiation: GATA3 (50%), S-100P (86%), uroplakin III (20%), thrombomodulin (40%), cytokeratin 7 (CK7) (80%), CK20 (55%), p63 (87%), and high molecular weight cytokeratin (HMCK) (89%); (b) urothelial carcinoma variants (micropapillary, plasmacytoid, nested, clear cell, and microcystic): GATA3 (88%), S-100P (96%), uroplakin III (33%), thrombomodulin (49%), CK7 (95%), CK20 (61%), p63 (69%), and HMCK (96%); and (c) undifferentiated carcinomas (lymphoepithelioma-like carcinoma, small cell carcinoma, sarcomatoid carcinoma and carcinoma with rhabdoid and giant cells): GATA3 (28%), S-100P (31%), uroplakin III (0%), thrombomodulin (22%), CK7 (50%), CK20 (3%), p63 (50%), and HMCK (49%). In urothelial carcinoma with squamous differentiation, GATA3 expression was lower (20%) in contrast to p63 and S-100P. In urothelial carcinoma with glandular differentiation, GATA3 (50%) and p63 (60%) expression was lower than S-100P (100%). p63 expression was relatively lower in micropapillary (54%) and plasmacytoid (50%) variants compared with the other urothelial carcinoma variants. This study provides comprehensive data for novel and traditionally used markers to support urothelial lineage in urothelial carcinoma variants. Our findings show that GATA3, S-100P, CK7, CK20, HMCK, and p63, in the appropriate differential diagnostic setting, are useful to support urothelial lineage of variant morphologies.

KEYWORDS:

GATA3; Immunohistochemistry; S-100P; Undifferentiated; Urothelial; Variant

PMID:
24780825
DOI:
10.1016/j.humpath.2014.02.024
[Indexed for MEDLINE]

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