HER-2 ONCOPROTEIN EXPRESSION IN UROTHELIAL CARCINOMA

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HER-2 ONCOPROTEIN EXPRESSION IN UROTHELIAL CARCINOMA

Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 87

Abstract

BACKGROUND Low grade non-muscle invasive transitional cell carcinoma is associated with repeated recurrences and progression to high grade tumour. Non-muscle invasive transitional cell carcinoma is associated with poor oncological outcome. Therefore, this study was undertaken to evaluate the expression of HER-2 oncoprotein in transitional cell carcinoma and further to evaluate whether expression of this oncoprotein has relation with grade of tumour and invasion of muscle. The objective of this study is to evaluate the expression of HER-2 protein in low grade, high grade and muscle invasive transitional cell carcinoma using immunohistochemistry. MATERIALS AND METHODS It was a retrospective, descriptive study of duration of three years in which all cases of transitional cell carcinoma signed out in the Department of Pathology from January 2012 to December 2014 were included. All cases of transitional cell carcinoma signed out in the above-mentioned period were retrieved from surgical pathology files and consult files of Govt. Medical College, Jammu. Sample size was conveniently taken. In total, 104 cases were identified over a period of three years. Haematoxylin and eosin stained sections of 5 µm thickness were re-examined in all cases to confirm the diagnosis and grade the tumour. Immunohistochemistry for HER-2 protein was done in ten cases, each of low and high grade transitional cell carcinoma. Immunohistochemistry was also done in tumours invading muscle (18 cases). Clinical features and followup data was obtained from consult files and referring surgeons. Statistical analysis was performed using SPSS 10.0 for Windows student version (SPSS Inc., 233 South Wacker Drive, 11th Floor, Chicago, IL 60606-6412). Statistical tool like Fisher exact test was applied. This study was approved by Institutional Ethics Committee of Govt. Medical College, Jammu. RESULTS Age of the patients ranged from 22 to 86 years and mean age was 59.28 years. The common clinical presentation was haematuria (96.7%). Of total 104 cases, 83 (79.8%) were papillary urothelial carcinoma low grade and 21 (20.19%) were papillary urothelial high grade. Eighteen cases (17.30%) showed muscle invasion; 8 (80%) of ten cases of low grade papillary urothelial carcinoma were positive for HER-2. Six (60%) cases of high grade papillary urothelial carcinoma were positive HER-2; 14 (77.77%) of the 18 cases associated with muscle invasion showed HER-2 oncoprotein expression. CONCLUSION About three-quarters of urothelial carcinoma overexpress HER-2 and this is very promising for molecular targeted therapy and moreover HER-2 overexpression also has prognostic and diagnostic significance. We propose that immunohistochemistry for HER2 protein should be incorporated into the routine surgical pathology sign-out of urothelial carcinoma.

Authors and Affiliations

Surinder Kumar Atri, Virender Mohan Rana, Rahul Gupta

Keywords

Urothelial Carcinoma Erb HER-2/Neu Molecular Targeted Therapy.

EP ID EP277670
DOI 10.14260/jemds/2017/1302
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