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Papillary Urothelial Carcinoma of Urinary Bladder: A Comparative Study of The Immunohistochemical Staining Pattern of (Cytokeratin 20 and P16) And Its Relation to Tumor Grade and Other Factors
نورا مصطفى كريم
Authors : ZAM Abdel Wahab AR. Alshaikhly, Noora M. Kareem
Background: Bladder carcinoma is the 9th most common malignancy. Papillary urothelial carcinoma represents about 45% of all primary bladder tumors. Objectives: To compare between the immunohistochemical staining pattern of (CK20 and p16) of (non-neoplastic urinary bladder urothelium, low and high grade papillary urothelial carcinoma) and its relation to tumor grade and invasiveness. Methods: It was a retrospective study. Formalin fixed paraffin tissue blocks of papillary urothelial carcinoma for 48 patients, and an equal number of non-neoplastic cases were collected. Immunohistochemical marker study of two markers (P16 and CK20) staining pattern was performed. Results: CK20 stain was positive in (68.8%) of cases, while only (10.4%) of the controls was positive, with a p value of (0.002). p16 stain was positive in (70.8%) of cases, whereas its positivity in the controls was only (20.8%), and the p value was (0.003). CK20 was positive in 5 invasive cases but negative in 12 invasive cases. On the other hand CK20 was positive in 28 noninvasive cases and negative in only 3 noninvasive cases with a p value of (0.000). Significant difference (in favor for the non-invasive cases) in p16 expression was found between invasive and non-invasive urothelial carcinoma (p value 0.018). Conclusion: Both markers (CK20 and P16) are adequate and useful in assessing bladder biopsies and both can be used in routine practice to confirm the diagnosis of both low and high grade papillary urothelial carcinoma and P16 positivity may indicate a good prognosis in papillary urothelial carcinoma Background: Bladder carcinoma is the 9th most common malignancy. Papillary urothelial carcinoma represents about 45% of all primary bladder tumors. Objectives: To compare between the immunohistochemical staining pattern of (CK20 and p16) of (non-neoplastic urinary bladder urothelium, low and high grade papillary urothelial carcinoma) and its relation to tumor grade and invasiveness. Methods: It was a retrospective study. Formalin fixed paraffin tissue blocks of papillary urothelial carcinoma for 48 patients, and an equal number of non-neoplastic cases were collected. Immunohistochemical marker study of two markers (P16 and CK20) staining pattern was performed. Results: CK20 stain was positive in (68.8%) of cases, while only (10.4%) of the controls was positive, with a p value of (0.002). p16 stain was positive in (70.8%) of cases, whereas its positivity in the controls was only (20.8%), and the p value was (0.003). CK20 was positive in 5 invasive cases but negative in 12 invasive cases. On the other hand CK20 was positive in 28 noninvasive cases and negative in only 3 noninvasive cases with a p value of (0.000). Significant difference (in favor for the non-invasive cases) in p16 expression was found between invasive and non-invasive urothelial carcinoma (p value 0.018). Conclusion: Both markers (CK20 and P16) are adequate and useful in assessing bladder biopsies and both can be used in routine practice to confirm the diagnosis of both low and high grade papillary urothelial carcinoma and P16 positivity may indicate a good prognosis in papillary urothelial carcinoma paient.

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2017/9