A combination of p40, GATA-3 and uroplakin II shows utility in the diagnosis and prognosis of muscle-invasive urothelial carcinoma

Mariah Z. Leivo, Paul J. Elson, David E. Tacha, Brett Delahunt, Donna E. Hansel

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Recently developed antibodies against uroplakin II and ΔNp63 (p40) show utility in diagnosing primary bladder urothelial carcinoma, although application in metastatic bladder cancer and patient outcomes has been less well defined. We evaluated these antibodies by immunostain intensity and H-score, in conjunction with GATA-3 immunoreactivity, in 89 patients with muscle-invasive urothelial carcinoma and 35 paired metastasis. The maintenance of immunoreactivity in metastatic lesions and the association to disease recurrence and survival was assessed. Bladder urothelial carcinoma showed immunoreactivity for GATA-3 in 99% (88/89), p40 in 87% (77/89) and uroplakin II in 80% (71/89) of cases, with a positive correlation between GATA-3 and uroplakin II H-score (0.44; p < 0.0001). All lesions were positive for at least one marker, reinforcing the use of these markers as a panel. In 35 patients with paired lymph node metastasis, uroplakin II and GATA-3 were retained in 90% and 75% of patients, respectively, suggesting these markers may have relatively high sensitivity in diagnosing metastatic urothelial carcinoma. High intensity p40 immunostain (3+), however, was significantly associated with reduced patient survival (p = 0.03). These results suggest that whereas GATA-3 and uroplakin II may be most useful in the diagnosis of urothelial carcinoma metastasis, p40 may be additionally suited as a prognostic marker.

Original languageEnglish (US)
Pages (from-to)543-549
Number of pages7
JournalPathology
Volume48
Issue number6
DOIs
StatePublished - Oct 1 2016
Externally publishedYes

Keywords

  • Bladder cancer
  • GATA-3
  • immunohistochemistry
  • p40
  • survival
  • uroplakin II
  • urothelial carcinoma
  • ΔNp63

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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