Osmanov YI, Gaibov ZA, Kogan EA, Radenska-Lopovok SG, Tursunov KZ. [Comparative morphological characteristics and immunophenotype of urothelial carcinomas of the renal pelvis and bladder].
Arkh Patol 2019;
80:23-32. [PMID:
30335057 DOI:
10.17116/patol20188005123]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Urothelial carcinoma is one of the most frequently diagnosed malignant tumors of the bladder and upper urinary tract, which ranks seventh in the pattern of cancer. Urothelial carcinoma of the renal pelvis is less common; but has a more aggressive clinical course and a worse prognosis than that of the bladder. This is due to the clinical and morphological features of this form of cancer, which, unlike bladder cancer, have not been studied enough.
OBJECTIVE
To comparatively analyze the morphological and immunophenotypic parameters of urothelial carcinomas of the renal pelvis and bladder.
SUBJECT AND METHODS
Surgical specimens from 196 patients diagnosed with urothelial carcinoma of the renal pelvis and bladder were investigated. Paraffin sections were immunohistochemically examined using the standard protocol. Antibodies against CK5/6, CD138, CDX2 ('Dako'), CK7, CK14, CK20, CEA, CD10, CD117, EMA, E-Cadherin, HMWCK, p63, Uroplakin III, Vimentin ('Novocastra'), CD44, GATA-3, MUC1, MUC2, and MUC-5AC ('Cell Marque') were used.
RESULTS
Most tumors (n=147 (75%)) were invasive. Of them, 65 (33%) cases had a histological structure of conventional urothelial cancer; and 3 (1.5%) had paradoxical differentiation. Divergent tumor zones were verified in 66 (34%) neoplasms; 4 (2%) cases showed an inverted growth pattern. Pseudosarcomatous stroma reaction in the invasion zones was verified in 9 (5%) cases. The tumor stage corresponded to pT2-pT4 in 128 (65%) tumors.
CONCLUSION
Urothelial carcinomas of the renal pelvis and bladder show a broad spectrum of histological variants. The findings support that, unlike urothelial carcinomas of the bladder, the majority of primary urothelial carcinomas of the renal pelvis are high-grade and highly invasive.
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