scholarly journals Clinicopathological correlation of p63 in Urothelial Carcinoma: Immunohistochemical Study

2020 ◽  
Vol 7 (6) ◽  
pp. A269-274
Author(s):  
Rupinderjit Kaur ◽  
Mridu Manjari ◽  
Sanjay Piplani
Keyword(s):  
Urothelial Carcinoma ◽  
Tertiary Care ◽  
Staining Intensity ◽  
Good Prognosis ◽  
Health Concern ◽  
Low Grade ◽  
Care Hospital ◽  
High Grade ◽  
Female Ratio ◽  
Urothelial Carcinomas

Background: Urothelial cancer (UCa) poses a significant medical and public health concern in most parts of the world and is defined as a pan- urothelial disease in which entire urothelium of the renal pelvis to the urethra can undergo malignant transformation.  Bladder tumors account for 90–95% of urothelial carcinomas and are the most common urinary tract malignancy. It is three times less common in females. Methods: The study was conducted on 40 cases of Urothelial Carcinoma received as biopsy specimens in a tertiary care hospital. There were 20 cases each of low grade and high grade and after grading these were subjected to p63 expression. Result: 78% of the patients were from 50-75 year age group with Male to Female ratio being 4:1. Painless hematuria was most common complaint. The size varied from 0.5 to 7.2 cm. For P63, 38 (95%) cases showed positive p63 expression. Of which 20 cases were low grade and 18 (90%) were high grade papillary urothelial carcinomas. Of P63 positive cases 36 cases showed moderate to strong staining intensity whereas two cases showed mild staining intensity. The p63 expression decreased with grade and invasion. Conclusion:   P63 immunoexpression decreases with increasing grade of tumor as well as with invasion thus showing that its expression is related with good prognosis.

Clinicopathological study of urothelial neoplasms in urinary bladder with special reference to expression of Her2/neu and Ki-67 in malignant lesions

2021 ◽  
Vol 8 (3) ◽  
pp. 378-385
Author(s):  
Sarmila Sen ◽  
Ayesha Abid ◽  
Ranjana Bandyopadhyay
Keyword(s):  
Urothelial Carcinoma ◽  
Histological Grade ◽  
Tertiary Care ◽  
Population Group ◽  
Low Grade ◽  
Care Hospital ◽  
Ki 67 ◽  
Cross Sectional ◽  
Non Invasive ◽  
Urothelial Carcinomas

Urothelial carcinomas are the fourth most common tumors worldwide. Studies have shown that Her2/neu is associated with increased tumour grade and Ki‐67 is related to tumour recurrence and stage progression. As no such study has been undertaken is this region, the present study was aimed to establish Her2/neu and Ki-67 as novel prognostic markers of urothelial neoplasms.: To evaluate the clinical profile of urothelial neoplasms and correlate the expression of Her2/neu and Ki-67 in urothelial carcinomas.Observational and cross-sectional study (January 2018-May 2019) in a tertiary care hospital in Eastern India.: 40 specimens of urothelial neoplasms were studied. Clinical history of patients was collected. Microscopic examination was done to assess tumour stage and histological grade. Immunohistochemistry with Her2/neu and Ki-67 was performed.: Statistical Package for the Social Sciences SPSS (version 20.0, IBM, Chicago, IL, USA) for windows software.: 8 cases were diagnosed as low grade non-invasive urothelial carcinoma, 31 cases as infiltrating urothelial carcinoma and 1 case as papillary urothelial neoplasm of low malignant potential (PUNLMP). 96.8% of infiltrating carcinomas and 87.5% of low grade non-invasive carcinomas showed Ki-67 positivity. Moderate-to-strong Her2/neu overexpression (2+ or 3+) was observed in only 21% of the cases.: The expression of Ki-67 increased with increase in the grade of the tumour which was suggestive of the prognostic importance of Ki-67. Her2/neu positivity was seen in infiltrating cases. No significant association between the tumor grade and Her2/neu expression, indicated the need for further studies with a larger population group.

scholarly journals Interobserver reproducibility of The Paris System for Reporting Urinary Cytology

CytoJournal ◽  
2017 ◽  
Vol 14 ◽  
pp. 17 ◽  
Author(s):  
Theresa Long ◽  
Lester J. Layfield ◽  
Magda Esebua ◽  
Shellaine R. Frazier ◽  
D. Tamar Giorgadze ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Urinary Cytology ◽  
Low Grade ◽  
High Grade ◽  
Urothelial Cells ◽  
Urothelial Carcinomas ◽  
Absolute Agreement ◽  
Potential Impact ◽  
Urine Specimens

Background: The Paris System for Reporting Urinary Cytology represents a significant improvement in classification of urinary specimens. The system acknowledges the difficulty in cytologically diagnosing low-grade urothelial carcinomas and has developed categories to deal with this issue. The system uses six categories: unsatisfactory, negative for high-grade urothelial carcinoma (NHGUC), atypical urothelial cells, suspicious for high-grade urothelial carcinoma, high-grade urothelial carcinoma, other malignancies and a seventh subcategory (low-grade urothelial neoplasm). Methods: Three hundred and fifty-seven urine specimens were independently reviewed by four cytopathologists unaware of the previous diagnoses. Each cytopathologist rendered a diagnosis according to the Paris System categories. Agreement was assessed using absolute agreement and weighted chance-corrected agreement (kappa). Disagreements were classified as low impact and high impact based on the potential impact of a misclassification on clinical management. Results: The average absolute agreement was 65% with an average expected agreement of 44%. The average chance-corrected agreement (kappa) was 0.32. Nine hundred and ninety-nine of 1902 comparisons between rater pairs were in agreement, but 12% of comparisons differed by two or more categories for the category NHGUC. Approximately 15% of the disagreements were classified as high clinical impact. Conclusions: Our findings indicated that the scheme recommended by the Paris System shows adequate precision for the category NHGUC, but the other categories demonstrated unacceptable interobserver variability. This low level of diagnostic precision may negatively impact the applicability of the Paris System for widespread clinical application.

scholarly journals Incidence of various urothelial malignancy in patients undergoing transurethral resection of bladder tumour in tertiary care hospital

2020 ◽  
Vol 8 (1) ◽  
pp. 346
Author(s):  
Kamal Preet Kaur ◽  
Gurpreet Singh Bhangu ◽  
Darpan Bansal ◽  
Divya Julka
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
High Grade ◽  
Urothelial Malignancy ◽  
Papillary Urothelial Carcinoma

Background: Urinary bladder lesions are a great health concern as it lies among the top ten most common cancers in the world. These range from benign, harmless lesions that do not recur to life threatening tumors. The present study was undertaken to study incidence of various urothelial cancer in patients undergoing transurethral resection of bladder tumor in tertiary care hospital, as the treatment, follow up and prognosis is highly variable with different subtypes of bladder cancer.Methods: A hospital based descriptive cross-sectional study was conducted on all patients undergoing transurethral resection of bladder tumor from December 2018 to May 2020 in the Department of General Surgery of Sri Guru Ramdas Institute of Medical Sciences and Research, Amritsar. Based on World Health Organization (WHO) classification incidence of various urothelial malignancy was calculated.Results: Out of 80 patients with growth urinary bladder, 4 patients (5% of total patient) were diagnosed as case of papilloma, 26 patients (32.5% of total patients) were diagnosed as low grade papillary urothelial carcinoma, 50 patients (62.5% of total patients) were of high grade papillary urothelial carcinoma. There were no case of PUNLMP in our study.Conclusions: It can be concluded that majority of the patient undergoing transurethral resection of bladder tumor are diagnosed with high grade papillary carcinoma. 

scholarly journals LOW GRADE UROTHELIAL CARCINOMA

2018 ◽  
Vol 23 (11) ◽  
pp. 1323-1327
Author(s):  
Amjad Ali Khan ◽  
Dr. Abdul Shaheed Asghar ◽  
Muhammad Ishaq ◽  
Israr Ahmed Akhund
Keyword(s):  
Urothelial Carcinoma ◽  
Nuclear Membrane ◽  
Low Grade ◽  
High Grade ◽  
Primary Tumors ◽  
Indwelling Catheters ◽  
Medical College ◽  
Non Invasive ◽  
Urothelial Carcinomas ◽  
Cytological Features

Objectives: Urine cytology is an easy to perform non-invasive screening test forpatients who are suspected of having urinary tract malignancy. Urothelial carcinoma constitutesapproximately 90% of all primary tumors of urinary bladder.1 High-grade urothelial carcinomasare represented by well characterized cytological features. Whereas cytological features forlow-grade urothelial carcinomas show considerable overlap with features secondary to chronicinflammation, calculi, indwelling catheters or effects of intra-vesical chemotherapy.2 Thepurpose of this study is to find an appropriate set of cytological features of shed urothelial cellsthat will be useful to differentiate low-grade urothelial carcinoma cells from atypical urothelialcells secondary to non-neoplastic conditions. Study Design: Retrospective study. Setting:Charsada Teaching Hospital affiliated with Jinnah Medical College Peshawar. Period: 2010to 2015. Methods: All cases of urine and bladder washing cytology were retrieved for threediagnostic categories namely: low-grade urothelial carcinoma (LGUC), high-grade urothelialcarcinoma (HGUC), and “atypical urothelial cells”; for which histological diagnoses were alsoavailable. These cases were reviewed for cell clusters with smooth or irregular communityborders, cytoplasm texture, nucleomegaly, high nucleus to cytoplasm ratios (N/C ratio),presence of nucleoli, nuclear membrane irregularity, and chromatin texture. Results: Cellclusters with smooth borders were common in reactive changes, whereas irregular communityborders were seen in low-grade urothelial carcinomas and dyscohesive pattern was a featureof HGUC. The increase in N/C ratio ›2:1 was always associated with malignancy. The nuclearmembrane irregularity was also a strong indicator of malignancy. Cytoplasmic homogeneityand nuclear hyperchromasia were more prominent and consistently seen in high-gradeurothelial carcinomas. Conclusions: The study showed that nuclear membrane irregularity,nucleomegaly and high N/C ratio of › 2:1 were the most consistent features found in LGUC.These features can be used with high certainty to differentiate LGUC (malignant) from atypicalurothelial cells (non-neoplastic).

Utility of GATA-3 and Cytokeratin 5/6 Immunostains in Separating Condyloma Acuminatum Arising in the Urinary Tract From Non-Invasive Papillary Urothelial Carcinoma

2021 ◽  
pp. 106689692110522
Author(s):  
Diego Montoya-Cerrillo ◽  
Laurence M. Briski ◽  
Merce Jorda ◽  
Oleksandr N. Kryvenko
Keyword(s):  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Condylomata Acuminata ◽  
Condyloma Acuminatum ◽  
Low Risk ◽  
Low Grade ◽  
High Grade ◽  
Non Invasive ◽  
Urothelial Carcinomas ◽  
Papillary Urothelial Carcinoma

Background Condyloma acuminatum is a squamous epithelial lesion which uncommonly involves the urinary tract. In this location, non-invasive papillary urothelial carcinoma constitutes one of the main differential diagnoses with significant prognostic and therapeutic implications. To date, no ancillary immunohistochemical stain has been described to differentiate these two entities. We assess the utility of cytokeratin 5/6 (CK5/6) and GATA-3 immunohistochemistry in distinguishing condyloma acuminatum from non-invasive papillary urothelial carcinoma. Design We reviewed 9 condylomata acuminata involving the urinary tract, 12 low-grade and 8 high-grade non-invasive papillary urothelial carcinomas. CK5/6 immunostaining was performed in all cases. GATA-3 immunostaining and low-risk human papilloma virus (HPV) chromogenic in situ hybridization was performed in all condyloma cases and 2 urothelial carcinomas with squamous differentiation. Results 8/9 condylomata acuminata were positive for low-risk HPV. All condylomata acuminata exhibited strong full-thickness cytoplasmic staining for CK5/6. In 10 of 12 low-grade non-invasive papillary urothelial carcinomas, CK5/6 expression was continuous and limited to the basal cell layer, while it was patchy and limited to the basal cell layer in all 8 high-grade non-invasive papillary urothelial carcinomas. Two low-grade non-invasive papillary urothelial carcinomas showed focal full-thickness CK5/6 expression in the areas of squamous differentiation. These 2 cases were negative for low-risk HPV. GATA-3 immunostaining was positive in all condylomata acuminata. Conclusions CK5/6 immunostaining is a useful and simple tool that can help separate low-grade and high-grade non-invasive papillary urothelial carcinomas from condyloma acuminatum involving the urothelium-lined organs. GATA-3 has no discriminatory role between condyloma acuminatum and papillary urothelial carcinomas.

Clinico-demographic Characteristics of Patients with Cirrhosis of Liver : Experienced at a Tertiary Care Hospital

2013 ◽  
Vol 20 (Number 1) ◽  
pp. 8-14
Author(s):  
AKM S Kabir ◽  
Md. F Alam ◽  
C K Ghosh ◽  
S N Ahmed ◽  
S Sikder
Keyword(s):  
Weight Loss ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Demographic Characteristics ◽  
Global Perspective ◽  
Low Grade ◽  
Care Hospital ◽  
Female Ratio ◽  
History Of ◽  
Cirrhosis Of Liver

Cirrhosis of liver is one of the commonest hepatobiliary problems in Bangladesh as well as in global perspective. The purpose of the present study was to find out the clinico-demographic characteristics of liver cirrhosis patients admitted at a tertiary care hospital. Patients who are clinically suspected to have cirrhosis of liver, admitted in medicine units of Holy Family Red Crescent Medical College Hospital, Dhaka have been analyzed regarding clinical presentation and complications profile. Total 100 patients were included of which 84% were cirrhosis of liver, 7% were chronic active hepatitis, 3% were chronic persistent hepatitis, 2% were Wilson's disease with cirrhosis and 4% were hepatocellular carcinoma (HCC) on the top of cirrhosis of liver. The peak age incidence was between 31-50 years with male-female ratio of 4.88:1. History of jaundice (42%), parenteral medications (14%), infusion (6%) and abdominal surgery (4.0%) were important findings from patient's past history. History of alcohol intake was found in only 4% cases. Overall, weakness (78%), anorexia (72%), abdominal swelling (74%), weight loss (64%), ankle swelling (42%), low grade fever (35%) and yellowish discolouration of eyes, skin and urine (37%) were the most common symptoms. Common signs, revealed by clinical examination as a whole, were anaemia (55%), ascites (68%), oedema (52%), jaundice (34%), palpable spleen (55%) and hepatic facies (37%). Cirrhosis of liver most commonly occurs in middle aged male patients. Weakness, weight loss, anorexia, abdominal discomfort/dyspepsia and swelling of the abdomen are the most prevalent symptoms.

scholarly journals HISTOPATHOLOGICAL SPECTRUM OF UROTHELIAL LESIONS: AN OBSERVATIONAL STUDY

2020 ◽  
pp. 1-4
Author(s):  
Nishat Ahmad ◽  
Saurabh Banerjee ◽  
A K. Srivastava
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Bladder Tumour ◽  
Histopathological Analysis ◽  
Low Grade ◽  
High Grade ◽  
Urothelial Carcinomas ◽  
Neoplastic Lesions ◽  
Papillary Urothelial Carcinoma ◽  
Muscle Invasion

BACKGROUND: Urinary bladder cancer is second most common cancer after prostate cancer in the genitourinary system. Urothelial Carcinoma is the commonest tumour type accounting for 90% of all primary tumours of the bladder Histopathological analysis of cystoscopic bladder biopsy and Transurethral resection of the bladder tumour (TURBT) material are the mainstay for cancer diagnosis. This study was aimed to determine the frequency of different types of neoplastic lesions of the urinary bladder and to determine the grade and stage of urothelial tumours. MATERIAL METHOD: The study was carried out in the Department of Pathology, Rajendra Institute of Medical Sciences (RIMS), Ranchi from January 2018 to June 2020 and included 30 cases of cystoscopic biopsies and TURBT specimens. RESULTS: Out of 30 cases of neoplastic lesions, majority were of high grade papillary urothelial carcinoma (n=14, 46.67%) followed by low grade papillary urothelial carcinoma (n=9, 30%), 3 cases (10%) were of PUNLMP, 2 cases (6.66%) of papilloma and 1 (3.33%) case each of moderately differentiated squamous cell carcinoma and extra nodal NHL. The most common age group was 41-50 years and 51-60 years with 9 (30%) cases each. Muscle invasion was seen only in high grade papillary urothelial carcinomas. CONCLUSION: High-grade urothelial carcinomas with lamina propria and muscle invasion are the most common neoplastic lesion of urinary bladder with significant morbidity and mortality. Muscle invasion and grading, as per TNM staging, are valuable prognostic factors.

scholarly journals Intense expression of Neurokinin-1 Receptor is associated with Urothelial carcinoma

2020 ◽  
Author(s):  
Riffat Mehboob ◽  
Amber Hassan ◽  
Shahida Perveen ◽  
Syed Amir Gilani ◽  
Humera Waseem ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Cancer Progression ◽  
Tertiary Care ◽  
Low Grade ◽  
Care Hospital ◽  
Peripheral Tissues ◽  
Inflammatory Reactions ◽  
Neurokinin 1 Receptor ◽  
Regulatory Effects ◽  
Neurokinin 1

ABSTRACTI+ntroductionSubstance P (SP)/ Neurokinin-1 Receptor (NK-1R), induces inflammatory reactions in peripheral tissues but its regulatory effects in target tissues are dependent on receptor signaling. SP has a high affinity for the NK-1 receptor, to which it binds preferentially. SP/NK-1R complex plays a key role in the interaction in the onset of pain and inflammation.ObjectiveThe aim of this study was to investigate the expression of NK-1R in Urotheilial carcinoma and its association with cancer progression.MethodThe study included ten biopsy samples of Urinary bladder, obtained retrospectively from a tertiary care hospital of Lahore. An Immunohistochemical study was performed using monoclonal antibodies against NK-1R. The presence or absence of staining and the intensity of the immunoreactivity were noted, as well as the number and type of cells. Evaluation of the Immunohistochemical expression was determined by the semi-quantitative method and scored.ResultNK-1 receptor was intensely expressed in patients with higher grade Urotheilial carcinoma. The cases clinically diagnosed as High Grade Urotheilial Carcinoma showed intense expression of NK-1R. However, the cases clinically diagnosed as low grade Urotheilial carcinoma showed very weak staining with NK-1R. However, the normal margins of the same tissue showed negative expression.ConclusionsElevated expression of NK-1R was associated with advanced stage of urothelial carcinoma. It is the first study to our knowledge to report this association. It may serve as a good diagnostic as well as prognostic marker and therapeutic strategy.

scholarly journals Pathological Characteristics of Primary Bladder Carcinoma Treated at a Tertiary Care Hospital and Changing Demographics of Bladder Cancer in Sri Lanka

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
S. Sasikumar ◽  
K. S. N. Wijayarathna ◽  
K. A. M. S. Karunaratne ◽  
U. Gobi ◽  
A. Pathmeswaran ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Sri Lanka ◽  
Bladder Carcinoma ◽  
Carcinoma In Situ ◽  
De Novo ◽  
Tertiary Care ◽  
Care Hospital ◽  
High Grade ◽  
Female Ratio

Objectives. The aim was to compare demographics and pathological features of bladder carcinoma treated in a urology unit with findings of previous studies done in Sri Lanka.Materials and Methods. Data of newly diagnosed patients with bladder cancer in a tertiary referral centre from 2011 to 2014 were analysed. Data on bladder cancers diagnosed from 1993 to 2014 were obtained from previous publications and Sri Lanka Cancer Registry.Results. There were 148 patients and mean age was 65 years. Male to female ratio was 4.1 : 1. Urothelial carcinoma (UC) was found in 89.2% of patients. Muscle invasion was noted in 35% of patients compared to 48.4% two decades ago. In patients with UC, 16.5% were found to have pT1high grade tumour. It was 5.3% from 1993 to 2000. Pure squamous cell carcinoma was found in 8.1% of patients while primary or de novo carcinoma in situ (not associated with high grade pT1tumours) was seen in one patient only.Conclusions. The percentage of squamous carcinoma is higher among Sri Lankan patients while primary carcinoma in situ is a rarity. The percentage of muscle invasive disease has decreased while the percentage of pT1high grade tumours has increased during the last two decades in Sri Lanka.

Utility of Urine Cytology in Genitourinary Lesions and Implication of Paris System in the Diagnosis of Urothelial Carcinoma - Five Years of Experience from a Tertiary Care Centre at North Karnataka

2021 ◽  
Vol 8 (02) ◽  
pp. 58-63
Author(s):  
Ranjana Shashidhar Ranade ◽  
Netra Prakash Kori ◽  
Vidisha Sharatchandra Athanikar
Keyword(s):  
Diagnostic Accuracy ◽  
Urothelial Carcinoma ◽  
Predictive Accuracy ◽  
Tertiary Care ◽  
Urine Cytology ◽  
Low Grade ◽  
High Grade ◽  
Tertiary Care Centre ◽  
Screening And Surveillance ◽  
Reporting Systems

BACKGROUND Urine cytology when combined with cystoscopy remains a gold standard in screening and surveillance of urothelial carcinoma. Paris system for reporting urine cytology (PSRUC) gives seven well defined diagnostic criteria. We aimed to analyse utility of urine cytology in patients with urogenital symptoms, compare existing institutional system (EIS) with PSRUC and assess the performance of both reporting systems in predicting subsequent high-grade urothelial carcinoma on histopathology. METHODS A five year retrospective study included a total of 146 urine samples from 74 patients. Each case was assigned a category according to both EIS and PSRUC system. After cyto-histological correlation, sensitivity, specificity and diagnostic accuracy of urine cytology in detecting malignancy using PSRUC and EIS were determined. Performance of urine cytology in predicting subsequent high grade urothelial carcinoma (HGUC) was assessed for both reporting systems. RESULTS PSRUC resulted in reduction in number of cases assigned to atypical category (10.5 % vs. 3.4 %) and increase in low grade carcinomas assigned to NGUC category (66 % vs. 100 %). Positive predictive value (PPV) for predicting subsequent high grade urothelial carcinoma for HGUC and SHGUC category remained the same (100 %). Sensitivity (66.67 % vs. 55.5 %), specificity (100 % vs. 85.71 %) and diagnostic accuracy (81 % vs. 68.75 %) was improved with application of PSRUC when compared to EIS. Two cases of genitourinary tuberculosis were diagnosed. CONCLUSIONS PSRUC improves predictive accuracy of subsequent high-grade urothelial carcinoma on histopathology and it ensures uniformity in reporting. Judicious use of urine cytology might aid in early diagnosis of infectious conditions like tuberculosis. KEYWORDS PSRUC, Urine Cytology, High Grade Urothelial Carcinoma

Sign in / Sign up

Export Citation Format

Share Document