Pathology Department, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey.
Urology Department, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey.
Indian J Pathol Microbiol. 2022 Jul-Sep;65(3):604-609. doi: 10.4103/ijpm.ijpm_537_21.
The present study aims to identify basaloid and luminal molecular groups and the p53-like sub-group, which is a sub-group of the luminal group, using a specific immunohistochemical panel and investigate human epithelial growth factor receptor 2 (HER2)/Neu and Fascin expression in these groups to analyze their relationship with clinicopathological features and prognosis in a cohort of cases with muscle-invasive urothelial bladder carcinoma (MIBC).
An immunohistochemical panel that included GATA-3, CK20, CD44, and CK5/6 was used to identify molecular sub-groups based on expression in 44 cases of MIBC. HER2/Neu and Fascin expression in basal, luminal, and p53-like groups and the relationship with clinicopathological features and prognosis were investigated.
The distribution of the molecular sub-groups determined by immunohistochemistry was as follows: 23 luminal cases (52.3%), 16 basal cases (36.4%), and 5 (11.4%) p53-like cases. There was a statistically significant difference in tumor size across the groups, with the greatest size in the p53-like group (p = 0.001). A statistically significant difference was observed in HER2/Neu expression between the molecular sub-groups (p = 0.017). Comparison of survival and HER2/Neu scores revealed shorter survival in patients with an HER2/Neu score of 3 + compared to those with scores of 0, 1+, and 2+ (p = 0.109). Fascin immunoreactivity was more common in the p53-like and basal groups compared to the luminal group (p = 0.036).
Despite the limited number of cases in the MIBC group, our results support that HER2/Neu expression in the luminal sub-group and Fascin expression in basal and p53-like groups may be used as a negative prognostic marker. Multi-center studies that include large case series are warranted in this field.
本研究旨在使用特定的免疫组织化学组合来识别基底样和腔型分子亚群以及 p53 样亚群（腔型亚群的一个亚群），并研究这些亚群中人类表皮生长因子受体 2（HER2）/neu 和 Fascin 的表达，以分析它们与浸润性膀胱癌（MIBC）病例队列的临床病理特征和预后的关系。
使用包含 GATA-3、CK20、CD44 和 CK5/6 的免疫组化组合，根据 44 例 MIBC 中的表达来确定分子亚群。研究了基底样、腔型和 p53 样组中 HER2/neu 和 Fascin 的表达及其与临床病理特征和预后的关系。
免疫组织化学确定的分子亚群分布如下：23 例腔型病例（52.3%）、16 例基底样病例（36.4%）和 5 例 p53 样病例（11.4%）。各组之间肿瘤大小存在统计学差异，p53 样组最大（p = 0.001）。分子亚群之间的 HER2/neu 表达存在统计学差异（p = 0.017）。生存和 HER2/neu 评分的比较显示，HER2/neu 评分 3+的患者生存时间短于评分 0、1+和 2+的患者（p = 0.109）。与腔型组相比，p53 样和基底样组 Fascin 免疫反应性更常见（p = 0.036）。
尽管 MIBC 组的病例数量有限，但我们的结果支持腔型亚群中的 HER2/neu 表达和基底样和 p53 样亚群中的 Fascin 表达可作为预后不良的标志物。在该领域需要进行多中心研究，包括大型病例系列。
