Dalia M Badary1*, Abeer El Refaiy1, Thanaa Sotohy1, Mahmoud Nassar1, Moemen Hafez1 and Reda A2
1Department of Pathology, Assiut University, Egypt
2Department of Urology, Assiut University, Egypt
Background: Urothelial Carcinoma (UC) develops through different pathways initiated by hyperplasia or CIS or chronic inflammation. So investigating the urothelium surrounding the tumour for molecular alterations can help in identifying patients would have more chance for occurrence of cancer and more likely to develop recurrences and progression to be targeted by appropriate therapy.
Materials and Methods: This study was conducted on 41 cases of UC which had adjacent areas of hyperplasia (n=33), CIS (n=23), inflammatory urothelium (n=15) and/or adjacent morphologically normal urothelium (n=8). Histological examination and immunohistochemical detection of FGFR3, HER2 AND COX2 in both tumor tissue and the adjacent urothelium was done
Results: There was significant association between FGFR3 positivity and papillary growth pattern, lower tumor grade and stage. HER2 positivity was found in 12.5% of morphologically normal urothelium adjacent to the tumor tissue indicating early molecular change in this microscopically cancer free tissue. There was high COX2 expression in non papillary pattern and in muscle invasive type with significant difference.
Conclusion: FGFR3 expression in UC is not only a characteristic feature of papillay pattern, low grade and low stage urothelial carcinoma, but also its over expression in hyperplastic urothelium could be a good indicator of occurrence of UC, HER2 and COX2 are known to have restricted expression in normal tissue so their expression in apparent microscopically normal tissue or in hyperplastic areas or in CIS indicates the high possibility of further malignant, high expression of HER2 and COX2 in CIS makes molecular targeted therapy against HER2 and COX2 has interesting potential to avoid possible progression.
Urothelial cell carcinoma; FGFR3; HER2; COX2
Badary DM, El Refaiy A, Sotohy T, Nassar M, Hafez M, Reda A. Comparative Immunohistochemical Study of Expression of FGFR3, HER2, COX2 in Transitional Cell Carcinoma vs. the Adjacent Urothelial Precancerous Changes. World J Clin Pathol. 2018;1(1):1003.