Pathology Department.
Urology Department, Faculty of Medicine, Zagazig University, Zagazig.
Appl Immunohistochem Mol Morphol. 2021 Jul 1;29(6):422-432. doi: 10.1097/PAI.0000000000000905.
Currently, the golden rule for the diagnosis of urothelial carcinoma is biopsy and cystoscopy, unfortionally both are costly, invasive, and uncomfortable. While most urothelial cancers are noninvasive at presentation, it is necessary to find a highly sensitive, noninvasive way to diagnose in its earlier stages, Cytology with immunostaining is a noninvasive, reliable method that might play a role in detecting the earlier stages before its progression and accurate correlation with different stages of these tumors.
This study aimed to reach an accurate level in the staging of urothelial carcinoma using CD44, ProExC, Laminin, and Fascin on urinary cytology.
We include a total of 180 urinary cytology specimens with their surgical biopsies' counterparts, the staging of the surgical specimens were done according to AJCC2017TNM classification, while their counterpart urinary samples were centrifuged and the sediment was used for H&E and immunocytochemical staining with CD44, ProExC, Laminin, and Fascin.
The diagnosis of Ta-stage tumors was done according to the following immunohistochemical (IHC) profile [positive (+ve) CD44, negative (-ve) proExC, -ve Laminin, and -ve Fascin] with 100% sensitivity, 100% specificity. The diagnosis of Tis stage tumors was done according to IHC profile [-ve CD44, +ve proExC, -ve Laminin, and -ve Fascin] with 100% sensitivity, 93% specificity. The diagnosis of T1 stage tumors according to IHC profile [-ve CD44, +ve proExC, +ve Laminin, and -ve Fascin] with 100% sensitivity, 97% specificity, The diagnosis of T2 and T3 stage tumors was done according to IHC profile [-ve CD44, +ve proExC, +ve Laminin and weak to moderate +ve Fascin] with 100% sensitivity, 92% specificity, while the diagnosis of T4 stage tumors according to the IHC profile [-ve CD44, +ve proExC, +ve Laminin, and intense +ve Fascin] with 100% sensitivity, 100% specificity.
Using (CD44, ProExC, Laminin, and Fascin) on urinary cytology is a simple, reliable, and noninvasive method for the staging of urothelial carcinoma with 99% total accuracy.
目前，诊断尿路上皮癌的金标准是活检和膀胱镜检查，但不幸的是，这两种方法都既昂贵又具有侵入性，且患者会感到不适。虽然大多数尿路上皮癌在出现时是非浸润性的，但有必要找到一种高度敏感、非侵入性的方法来在早期阶段进行诊断，免疫细胞化学细胞学是一种非侵入性、可靠的方法，可能在其进展前的早期阶段发挥作用，并与这些肿瘤的不同阶段进行准确的相关性。
本研究旨在使用尿路上皮细胞中的 CD44、ProExC、层粘连蛋白和 Fascin 达到尿路上皮癌分期的准确水平。
我们共纳入 180 例尿路上皮细胞细胞学标本及其手术活检标本，手术标本的分期根据 AJCC2017TNM 分类进行，而相应的尿样标本离心后，沉淀物用于 CD44、ProExC、层粘连蛋白和 Fascin 的 H&E 和免疫细胞化学染色。
Ta 期肿瘤的诊断依据免疫组化（IHC）特征[CD44 阳性（+ve），ProExC 阴性（-ve），层粘连蛋白阴性（-ve）和 Fascin 阴性（-ve）]，其灵敏度为 100%，特异性为 100%。Tis 期肿瘤的诊断依据 IHC 特征[-ve CD44，+ve proExC，-ve Laminin，-ve Fascin]，其灵敏度为 100%，特异性为 93%。T1 期肿瘤的诊断依据 IHC 特征[-ve CD44，+ve proExC，+ve Laminin 和 -ve Fascin]，其灵敏度为 100%，特异性为 97%。T2 和 T3 期肿瘤的诊断依据 IHC 特征[-ve CD44，+ve proExC，+ve Laminin 和弱至中度+ve Fascin]，其灵敏度为 100%，特异性为 92%，而 T4 期肿瘤的诊断依据 IHC 特征[-ve CD44，+ve proExC，+ve Laminin 和强+ve Fascin]，其灵敏度为 100%，特异性为 100%。
使用尿路上皮细胞中的（CD44、ProExC、层粘连蛋白和 Fascin）是一种简单、可靠、非侵入性的方法，用于尿路上皮癌的分期，总准确率为 99%。
