Classification of urothelial carcinoma by immunohistochemistry

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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]

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. 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/.