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Immunohistochemistry and Fluorescence In Situ Hybridization Can Inform the Differential Diagnosis of Low-Grade Noninvasive Urothelial Carcinoma with an Inverted Growth Pattern and Inverted Urothelial Papilloma.

Sun JJ, Wu Y, Lu YM, Zhang HZ, Wang T, Yang XQ, Sun MH, Wang CF - PLoS ONE (2015)

Bottom Line: Based on our analysis, Ki-67 and CK20 may be useful for the differential diagnosis of these two tumor types.Fluorescence in situ hybridization (FISH) can also provide important data in cases in which the malignant nature of an inverted urothelial neoplasm is unclear.LGNUC with an inverted growth pattern that is negative for both Ki-67 and CK20 can be positively detected using FISH.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Institute of Pathology, Fudan University, Shanghai, China.

ABSTRACT
Urothelial carcinoma (UC) comprises a heterogeneous group of epithelial neoplasms with diverse biological behaviors and variable clinical outcomes. Distinguishing UC histological subtypes has become increasingly important because prognoses and therapy can dramatically differ among subtypes. In clinical work, overlapping morphological findings between low-grade noninvasive UC (LGNUC), which exhibits an inverted growth pattern, and inverted urothelial papilloma (IUP) can make subclassification difficult. We propose a combination of immunohistochemistry (IHC) and molecular cytogenetics for subtyping these clinical entities. In our study, tissue microarray immunohistochemical profiles of Ki-67, p53, cytokeratin 20 (CK20) and cyclinD1 were assessed. Molecular genetic alterations such as the gain of chromosomes 3, 7 or 17 or the homozygous loss of 9p21 were also assessed for their usefulness in differentiating these conditions. Based on our analysis, Ki-67 and CK20 may be useful for the differential diagnosis of these two tumor types. Fluorescence in situ hybridization (FISH) can also provide important data in cases in which the malignant nature of an inverted urothelial neoplasm is unclear. LGNUC with an inverted growth pattern that is negative for both Ki-67 and CK20 can be positively detected using FISH.

No MeSH data available.


Related in: MedlinePlus

IHC results for the two tumor types.Ki-67 was negative for IUP (A) but positive for LGNUC with an inverted growth pattern (B). CK20 was negative for IUP (C) but positive for LGNUC with an inverted growth pattern (D). IUP (E) and LGNUC with an inverted growth pattern (F) were both positive for P53. IUP (G) and LGNUC with an inverted growth pattern (H) were both positive for CyclinD1.
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pone.0133530.g003: IHC results for the two tumor types.Ki-67 was negative for IUP (A) but positive for LGNUC with an inverted growth pattern (B). CK20 was negative for IUP (C) but positive for LGNUC with an inverted growth pattern (D). IUP (E) and LGNUC with an inverted growth pattern (F) were both positive for P53. IUP (G) and LGNUC with an inverted growth pattern (H) were both positive for CyclinD1.

Mentions: Ki-67 expression was significantly lower in IUP (Fig 3A), for which only 1 of 36 cases (2.8%) was positive, than in LGNUC with an inverted growth pattern (Fig 3B), for which 18 of 38 cases (47.4%) were positive (P<0.001). CK20 expression was significantly lower in IUP (Fig 3C), for which 2 of 36 cases (5.6%) were positive, than in LGNUC with an inverted growth pattern (Fig 3D), for which 14 of 38 cases (36.8%) were positive (P = 0.001). P53 expression was lower in IUP (Fig 3E), for which 10 of 36 cases (27.8%) were positive, than in LGNUC with an inverted growth pattern (Fig 3F), for which 16 of 38 cases (42.1%) were positive, but the difference between them was not statistically significant (P = 0.230). CyclinD1 expression was slightly lower in IUP (Fig 3G), for which 25 of 36 cases (69.4%) were positive, than in LGNUC with an inverted growth pattern (Fig 3H), for which 28 of 38 cases (73.7%) were positive, but the difference between them was not statistically significant (P = 0.798).


Immunohistochemistry and Fluorescence In Situ Hybridization Can Inform the Differential Diagnosis of Low-Grade Noninvasive Urothelial Carcinoma with an Inverted Growth Pattern and Inverted Urothelial Papilloma.

Sun JJ, Wu Y, Lu YM, Zhang HZ, Wang T, Yang XQ, Sun MH, Wang CF - PLoS ONE (2015)

IHC results for the two tumor types.Ki-67 was negative for IUP (A) but positive for LGNUC with an inverted growth pattern (B). CK20 was negative for IUP (C) but positive for LGNUC with an inverted growth pattern (D). IUP (E) and LGNUC with an inverted growth pattern (F) were both positive for P53. IUP (G) and LGNUC with an inverted growth pattern (H) were both positive for CyclinD1.
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4514649&req=5

pone.0133530.g003: IHC results for the two tumor types.Ki-67 was negative for IUP (A) but positive for LGNUC with an inverted growth pattern (B). CK20 was negative for IUP (C) but positive for LGNUC with an inverted growth pattern (D). IUP (E) and LGNUC with an inverted growth pattern (F) were both positive for P53. IUP (G) and LGNUC with an inverted growth pattern (H) were both positive for CyclinD1.
Mentions: Ki-67 expression was significantly lower in IUP (Fig 3A), for which only 1 of 36 cases (2.8%) was positive, than in LGNUC with an inverted growth pattern (Fig 3B), for which 18 of 38 cases (47.4%) were positive (P<0.001). CK20 expression was significantly lower in IUP (Fig 3C), for which 2 of 36 cases (5.6%) were positive, than in LGNUC with an inverted growth pattern (Fig 3D), for which 14 of 38 cases (36.8%) were positive (P = 0.001). P53 expression was lower in IUP (Fig 3E), for which 10 of 36 cases (27.8%) were positive, than in LGNUC with an inverted growth pattern (Fig 3F), for which 16 of 38 cases (42.1%) were positive, but the difference between them was not statistically significant (P = 0.230). CyclinD1 expression was slightly lower in IUP (Fig 3G), for which 25 of 36 cases (69.4%) were positive, than in LGNUC with an inverted growth pattern (Fig 3H), for which 28 of 38 cases (73.7%) were positive, but the difference between them was not statistically significant (P = 0.798).

Bottom Line: Based on our analysis, Ki-67 and CK20 may be useful for the differential diagnosis of these two tumor types.Fluorescence in situ hybridization (FISH) can also provide important data in cases in which the malignant nature of an inverted urothelial neoplasm is unclear.LGNUC with an inverted growth pattern that is negative for both Ki-67 and CK20 can be positively detected using FISH.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Institute of Pathology, Fudan University, Shanghai, China.

ABSTRACT
Urothelial carcinoma (UC) comprises a heterogeneous group of epithelial neoplasms with diverse biological behaviors and variable clinical outcomes. Distinguishing UC histological subtypes has become increasingly important because prognoses and therapy can dramatically differ among subtypes. In clinical work, overlapping morphological findings between low-grade noninvasive UC (LGNUC), which exhibits an inverted growth pattern, and inverted urothelial papilloma (IUP) can make subclassification difficult. We propose a combination of immunohistochemistry (IHC) and molecular cytogenetics for subtyping these clinical entities. In our study, tissue microarray immunohistochemical profiles of Ki-67, p53, cytokeratin 20 (CK20) and cyclinD1 were assessed. Molecular genetic alterations such as the gain of chromosomes 3, 7 or 17 or the homozygous loss of 9p21 were also assessed for their usefulness in differentiating these conditions. Based on our analysis, Ki-67 and CK20 may be useful for the differential diagnosis of these two tumor types. Fluorescence in situ hybridization (FISH) can also provide important data in cases in which the malignant nature of an inverted urothelial neoplasm is unclear. LGNUC with an inverted growth pattern that is negative for both Ki-67 and CK20 can be positively detected using FISH.

No MeSH data available.


Related in: MedlinePlus