Difference between revisions of "Classification of urothelial carcinoma by immunohistochemistry"

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A '''classification of [[urothelial carcinoma]] by immunohistochemistry''' can be done with three [[immunostains]].<ref name=pmid34103388 >{{cite journal |vauthors=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>
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==
*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 | | | | | | | | | A01 | | | | |A01='''[[Urothelial carcinoma]]'''}}
{{familytree | | | | |,|-|-|-|-|^|-|-|-|-|.|}}
{{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 | C01 | | | | C02 | | | | | | | | | | | |C01='''Genomically unstable'''<br>'''p16 +ve'''|C02='''Urothelial-like'''<br>'''p16 -ve'''}}
{{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,) is in keeping with UROTHELIAL CARCINOMA, LUMINAL TYPE, GENOMICALLY UNSTABLE.
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>
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===Double positive===
<pre>
The immunoprofile (GATA3 POSITIVE, CK5/6 POSITIVE) would be compatible with UROTHELIAL CARCINOMA, LUMINAL TYPE.
</pre>
==See also==
*[[Urothelial carcinoma]].


==References==
==References==

Latest revision as of 18:08, 8 March 2024

A classification of urothelial carcinoma by immunohistochemistry can be done with three immunostains.[1]

UCC IHC classification redirects here.

General

  • A large meta-analysis showed two markers (CK5/6, GATA3) can subclassify ~90% of urothelial carcinoma into prognostic groups.[2]

A simple classification of urothelial carcinoma by immunohistochemistry

 
 
 
 
 
 
 
 
Urothelial carcinoma
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Luminal type
GATA3 +ve
(CK5/6 -ve)
 
 
 
 
 
 
 
Basal type
CK5/6 +ve
(GATA3 -ve)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Genomically unstable
p16 +ve
 
 
 
Urothelial-like
p16 -ve
 
 
 
 
 
 
 
 
 
 
 

Notes:

  • GATA3 positive and CK5/6 positive cases are classified as luminal.[1]
  • GATA3 negative and CK5/6 negative are unclassified.[1]

Additional note:

  • CK20 is considered an alternate luminal marker.[3]

Prognosis

Basal is bad.[2] Luminal is lower risk.

IHC

Panel:

  • CK5/6.
  • GATA3.
  • p16.

Important note:

  • Twenty percent of the tumour cells is considered the cut-off for positive versus negative.[1]

Sign out

The immunoprofile (GATA3 POSITIVE, p16 POSITIVE, CK5/6 negative) is in keeping with UROTHELIAL CARCINOMA, LUMINAL TYPE, GENOMICALLY UNSTABLE.

The immunoprofile (GATA3 POSITIVE, p16 negative, CK5/6 negative) is in keeping with UROTHELIAL CARCINOMA, LUMINAL TYPE, UROTHELIAL-LIKE.

The immunoprofile (CK5/6 POSITIVE, GATA3 negative) is in keeping with UROTHELIAL CARCINOMA, BASAL TYPE.

Double positive

The immunoprofile (GATA3 POSITIVE, CK5/6 POSITIVE) would be compatible with UROTHELIAL CARCINOMA, LUMINAL TYPE.

See also

References

  1. ↑ 1.0 1.1 1.2 1.3 Olkhov-Mitsel E, Hodgson A, Liu SK, Vesprini D, Xu B, Downes MR (June 2021). "Three-antibody classifier for muscle invasive urothelial carcinoma and its correlation with p53 expression". J Clin Pathol. doi:10.1136/jclinpath-2021-207573. PMID 34103388.
  2. ↑ 2.0 2.1 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 (October 2016). "Meta-Analysis of the Luminal and Basal Subtypes of Bladder Cancer and the Identification of Signature Immunohistochemical Markers for Clinical Use". EBioMedicine 12: 105–117. doi:10.1016/j.ebiom.2016.08.036. PMC 5078592. PMID 27612592. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5078592/.
  3. ↑ Sikic D, Keck B, Wach S, Taubert H, Wullich B, Goebell PJ, Kahlmeyer A, Olbert P, Isfort P, Nimphius W, Hartmann A, Giedl J (2017). "Immunohistochemiocal subtyping using CK20 and CK5 can identify urothelial carcinomas of the upper urinary tract with a poor prognosis". PLoS One 12 (6): e0179602. doi:10.1371/journal.pone.0179602. PMC 5478149. PMID 28632777. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478149/.
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