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Classification of urothelial carcinoma by immunohistochemistry (view source)
Revision as of 18:08, 8 March 2024
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A '''classification of [[urothelial carcinoma]] by immunohistochemistry''' can be done with three [[immunostains]].<ref name=pmid34103388 >{{cite journal | | A '''classification of [[urothelial carcinoma]] by immunohistochemistry''' can be done with three [[immunostains]].<ref name=pmid34103388 >{{cite journal |authors=Olkhov-Mitsel E, Hodgson A, Liu SK, Vesprini D, Xu B, Downes MR |title=Three-antibody classifier for muscle invasive urothelial carcinoma and its correlation with p53 expression |journal=J Clin Pathol |volume= |issue= |pages= |date=June 2021 |pmid=34103388 |doi=10.1136/jclinpath-2021-207573 |url=}}</ref> | ||
''UCC IHC classification'' redirects here. | |||
==General== | ==General== | ||
===A simple classification of urothelial carcinoma=== | *A large meta-analysis showed two markers (CK5/6, GATA3) can subclassify ~90% of urothelial carcinoma into prognostic groups.<ref name=pmid27612592>{{cite journal |authors=Dadhania V, Zhang M, Zhang L, Bondaruk J, Majewski T, Siefker-Radtke A, Guo CC, Dinney C, Cogdell DE, Zhang S, Lee S, Lee JG, Weinstein JN, Baggerly K, McConkey D, Czerniak B |title=Meta-Analysis of the Luminal and Basal Subtypes of Bladder Cancer and the Identification of Signature Immunohistochemical Markers for Clinical Use |journal=EBioMedicine |volume=12 |issue= |pages=105–117 |date=October 2016 |pmid=27612592 |pmc=5078592 |doi=10.1016/j.ebiom.2016.08.036 |url=}}</ref> | ||
===A simple classification of urothelial carcinoma by immunohistochemistry=== | |||
{{familytree/start}} | {{familytree/start}} | ||
{{familytree | | | | | | | | | A01 | | | | |A01=[[Urothelial carcinoma]]}} | {{familytree | | | | | | | | | A01 | | | | |A01='''[[Urothelial carcinoma]]'''}} | ||
{{familytree | | | | |,|-|-|-|-|^|-|-|-|-|.|}} | {{familytree | | | | |,|-|-|-|-|^|-|-|-|-|.|}} | ||
{{familytree | | | | B01 | | | | | | | | B02|B01=Luminal type<br>GATA3 +ve | {{familytree | | | | B01 | | | | | | | | B02|B01='''Luminal type'''<br>'''GATA3 +ve'''<br>(CK5/6 -ve)|B02='''Basal type'''<br>'''CK5/6 +ve'''<br>(GATA3 -ve)}} | ||
{{familytree | |,|-|-|^|-|-|.| | | | | | | | | | | | |}} | {{familytree | |,|-|-|^|-|-|.| | | | | | | | | | | | |}} | ||
{{familytree | C01 | | | | C02 | | | | | | | | | | | |C01=Genomically unstable<br>p16 +ve|C02=Urothelial-like<br>p16 -ve}} | {{familytree | C01 | | | | C02 | | | | | | | | | | | |C01='''Genomically unstable'''<br>'''p16 +ve'''|C02='''Urothelial-like'''<br>'''p16 -ve'''}} | ||
{{familytree/end}} | {{familytree/end}} | ||
Notes: | |||
*GATA3 ''positive'' and CK5/6 ''positive'' cases are classified as ''luminal''.<ref name=pmid34103388/> | |||
*GATA3 ''negative'' and CK5/6 ''negative'' are ''unclassified''.<ref name=pmid34103388/> | |||
Additional note: | |||
*[[CK20]] is considered an alternate luminal marker.<ref name=pmid28632777 >{{cite journal |authors=Sikic D, Keck B, Wach S, Taubert H, Wullich B, Goebell PJ, Kahlmeyer A, Olbert P, Isfort P, Nimphius W, Hartmann A, Giedl J |title=Immunohistochemiocal subtyping using CK20 and CK5 can identify urothelial carcinomas of the upper urinary tract with a poor prognosis |journal=PLoS One |volume=12 |issue=6 |pages=e0179602 |date=2017 |pmid=28632777 |pmc=5478149 |doi=10.1371/journal.pone.0179602 |url=}}</ref> | |||
===Prognosis=== | |||
'''B'''asal is '''b'''ad.<ref name=pmid27612592>{{cite journal |authors=Dadhania V, Zhang M, Zhang L, Bondaruk J, Majewski T, Siefker-Radtke A, Guo CC, Dinney C, Cogdell DE, Zhang S, Lee S, Lee JG, Weinstein JN, Baggerly K, McConkey D, Czerniak B |title=Meta-Analysis of the Luminal and Basal Subtypes of Bladder Cancer and the Identification of Signature Immunohistochemical Markers for Clinical Use |journal=EBioMedicine |volume=12 |issue= |pages=105–117 |date=October 2016 |pmid=27612592 |pmc=5078592 |doi=10.1016/j.ebiom.2016.08.036 |url=}}</ref> | |||
'''L'''uminal is '''l'''ower risk. | |||
==IHC== | |||
Panel: | |||
*CK5/6. | |||
*GATA3. | |||
*p16. | |||
Important note: | |||
*Twenty percent of the tumour cells is considered the '''cut-off''' for ''positive'' versus ''negative''.<ref name=pmid34103388/> | |||
==Sign out== | ==Sign out== | ||
<pre> | <pre> | ||
The immunoprofile (GATA3 POSITIVE, p16 POSITIVE, CK5/6 negative | The immunoprofile (GATA3 POSITIVE, p16 POSITIVE, CK5/6 negative) is in keeping with UROTHELIAL CARCINOMA, LUMINAL TYPE, GENOMICALLY UNSTABLE. | ||
</pre> | </pre> | ||
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<pre> | <pre> | ||
The immunoprofile (CK5/6 POSITIVE, GATA3 negative) is in keeping with UROTHELIAL CARCINOMA, BASAL TYPE. | The immunoprofile (CK5/6 POSITIVE, GATA3 negative) is in keeping with UROTHELIAL CARCINOMA, BASAL TYPE. | ||
</pre> | |||
===Double positive=== | |||
<pre> | |||
The immunoprofile (GATA3 POSITIVE, CK5/6 POSITIVE) would be compatible with UROTHELIAL CARCINOMA, LUMINAL TYPE. | |||
</pre> | </pre> | ||