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 |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>
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 large meta-analysis showed two markers (CK5/6, GATA3) can subclassify ~90% of urothelial carcinoma into prognostic groups.<ref>{{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 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===
===A simple classification of urothelial carcinoma by immunohistochemistry===
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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==
==IHC==
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*p16.
*p16.


Notes:
Important note:
*Twenty percent of the tumour cells is considered the cut-off for ''positive'' and ''negative''.<ref name=pmid34103388/>
*Twenty percent of the tumour cells is considered the '''cut-off''' for ''positive'' versus ''negative''.<ref name=pmid34103388/>
 
*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/>


==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>
<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>


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