Uropathology
Evelyn - Angel
Abstract
The progression and recurrence of urothelial carcinoma (UC) are correlated with carcinoma in situ and urothelial dysplasia. It is frequently challenging to distinguish dysplasia and carcinoma in situ from reactive atypia only based on histological characteristics. In daily practices, 2 of the adjunct ...
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The progression and recurrence of urothelial carcinoma (UC) are correlated with carcinoma in situ and urothelial dysplasia. It is frequently challenging to distinguish dysplasia and carcinoma in situ from reactive atypia only based on histological characteristics. In daily practices, 2 of the adjunct immunohistochemistry markers (cytokeratin 20 (CK20) and p53) are used in addition to the histology to diagnose carcinoma in situ. This is accomplished by combining histological research results with immunohistochemistry. This systematic review summarizes the current findings on the diagnostic significance of p53 and CK20 as adjunct markers to urine cytology in the detection of UC. A systematic search of the relevant literature was conducted using PubMed, Wiley Online Library, and ScienceDirect databases. After screening for the eligibility criteria, a total of 14 selected articles were reviewed. Data extraction included a total number of samples, specimen samples, type of cells, and outcome parameters (mainly sensitivity and specificity). Urine cytology alone had a sensitivity of 75%-85% and specificity of 66%-95%. CK20 with urine cytology staining showed improved sensitivity and specificity in the range of 77%-94% and 71%-100%, respectively; p53 immunostaining with urine cytology showed a sensitivity of 52%-86% and specificity of 80%-98%. The dual staining in combination with urine cytology showed comparatively higher sensitivity and specificity in the range of 70%-90% and 74%-100%, respectively. This was more evident for high-grade UC (HGUC). Overall, single or dual staining combined with urine cytology was effective in this detection and can be applied as an adjunct marker in urine cytology.
Mohammad Hossein Ghaini; Shaghayegh Sadat Esmailnejad; Ali Davati
Volume 7, Issue 3 , July 2012, , Pages 145-150
Abstract
Background and Aims: Immunohistochemical tests are one of the most important tests, which are under study to determine the prognosis of the cancers such as transitional cell carcinoma. By the time, flexible cystoscopy and urine cytology are the routine tests for following up the patients with transitional ...
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Background and Aims: Immunohistochemical tests are one of the most important tests, which are under study to determine the prognosis of the cancers such as transitional cell carcinoma. By the time, flexible cystoscopy and urine cytology are the routine tests for following up the patients with transitional cell carcinoma, which are both operator dependent. On the other hand, cystoscopy is an invasive method, and urine cytology is a method with low sensitivity. The aim of this study was to determine CK20 in patients with transitional cell carcinoma of bladder and its relation with prognostic factors, which are the stage and the grade of the tumor.
Materials and Methods: Our study was done in Mostafa Khomeini Hospital from 2007 to 2010 on the 2001 to 2009 stored information files, included 53 patients diagnosed as transitional cell carcinoma of bladder (TCC) of different stages and grades that were underwent total cystectomy. Immunohistochemical staining was performed on tissue sections with specific CK20 antibody. Then the samples were studied by light microscope so positive and negative cases were identified.
Results: According to statistical analysis there were significant reverse relationship between CK20 and stage, and significant reverse relationship between CK20 and grade (P= 0.000).
Conclusion: Immunohistochemical study of patients with transitional cell carcinoma of bladder in order to identify CK20 can be a useful method to determine the prognosis of these patients.