Agarwal Harshita, Babu Suresh, Rana Chanchal, Kumar Madhu, Singhai Atin, Shankhwar Shiv Narayan, Singh Vishwajeet, Sinha Rahul Janak
Department of Pathology, King George Medical University, Lucknow, Uttar Pradesh, India.
Indian J Pathol Microbiol. 2019 Apr-Jun;62(2):244-250. doi: 10.4103/IJPM.IJPM_228_18.
This study aims to explore the utility of GATA binding protein 3, a zinc finger transcription factor, expression in genitourinary carcinoma, especially urothelial carcinoma.
It is a prospective study where 74 consecutive cases of urothelial carcinoma along with 10 cases each of prostatic adenocarcinoma (PC) and conventional clear cell renal cell carcinoma were included between August 2016 and January 2017.
All the cases were histopathologically evaluated and immunohistochemically stained for GATA binding protein 3. Only nuclear positivity was considered as positive. Immunoreactivity score for GATA expression was calculated based on the staining intensity as well as percentage.
The statistical analysis was done using Statistical Package for Social Sciences Version 15.0 statistical analysis software. P value of <0.05 was considered statistically significance.
GATA3 expressions were seen in 77% of the cases of urothelial carcinoma, whereas none of the clear cell renal cell carcinoma and prostatic adenocarcinoma cases was GATA3 positive. GATA3 expression significantly correlated with histological grade and muscle invasion with a weaker or negative expression in high-grade muscle invasive tumor as compared to low-grade and noninvasive neoplasm. Significantly weaker expression of GATA3 was found in cases with severe nuclear pleomorphism, mitosis >10/10 hpf, presence of necrosis, and tumor-infiltrating lymphocytes. No significant change in the status of GATA3 expression was seen in follow-up cases between initial Transurethral resection of bladder tumor (TURBT) and post-recurrence TURBT or radical cystectomy specimens.
GATA3 as a sensitive and specific marker for urothelial carcinoma can be effectively used to exclude other genitourinary malignancies, PC, and renal cell carcinoma, at metastatic site. This marker can also be effectively used in predicting the probable grade and invasion in biopsy material with poor morphological characteristics, thereby helping in appropriate management in such cases.
本研究旨在探讨锌指转录因子GATA结合蛋白3在泌尿生殖系统癌，尤其是尿路上皮癌中的表达情况及其应用价值。
这是一项前瞻性研究，纳入了2016年8月至2017年1月期间连续收治的74例尿路上皮癌患者，以及各10例前列腺腺癌（PC）和传统透明细胞肾细胞癌患者。
所有病例均进行组织病理学评估，并对GATA结合蛋白3进行免疫组织化学染色。仅细胞核阳性被视为阳性。根据染色强度和百分比计算GATA表达的免疫反应评分。
使用社会科学统计软件包第15.0版统计分析软件进行统计分析。P值<0.05被认为具有统计学意义。
77%的尿路上皮癌病例可见GATA3表达，而透明细胞肾细胞癌和前列腺腺癌病例均无GATA3阳性。GATA3表达与组织学分级和肌肉浸润显著相关，与低级别和非浸润性肿瘤相比，高级别肌肉浸润性肿瘤中GATA3表达较弱或呈阴性。在具有严重核异型性、有丝分裂>10/10 hpf（高倍视野）、存在坏死和肿瘤浸润淋巴细胞的病例中，GATA3表达明显较弱。在随访病例中，最初的膀胱肿瘤经尿道切除术（TURBT）与复发后TURBT或根治性膀胱切除术标本之间，GATA3表达状态无显著变化。
GATA3作为尿路上皮癌的敏感和特异性标志物，可以有效地用于排除转移部位的其他泌尿生殖系统恶性肿瘤、PC和肾细胞癌。该标志物还可有效地用于预测形态学特征较差的活检材料的可能分级和浸润情况，从而有助于此类病例的合理管理。
