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Hasan A, Mohammed Y, Basiony M, Hanbazazh M, Samman A, Abdelaleem MF, Nasr M, Abozeid H, Mohamed HI, Faisal M, Mohamed E, Ashmawy D, Tharwat M, Morsi DF, Farag AS, Ahmed EM, Aly NM, Abdel-Hamied HE, Salama DEA, Mandour E. Clinico-Pathological Features and Immunohistochemical Comparison of p16, p53, and Ki-67 Expression in Muscle-Invasive and Non-Muscle-Invasive Conventional Urothelial Bladder Carcinoma. Clin Pract 2023; 13:806-819. [PMID: 37489422 PMCID: PMC10366752 DOI: 10.3390/clinpract13040073] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/02/2023] [Accepted: 07/05/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION The identification of bladder detrusor muscle invasion in urothelial cancer is essential for prognosis and management. We studied the clinical, histological, and immunohistochemical expression of p16, p53, and Ki-67 in urothelial detrusor muscle-invasive bladder cancer (MIBC) and urothelial non-detrusor muscle-invasive bladder cancer (NMIBC) in Egyptian patients. METHODS Sixty-two bladder urothelial cancer cases obtained through TURBT were included and divided into two groups: (MIBC, stage T2) and NMIBC (T1). Tissue blocks were recut and re-examined microscopically; then, the immunostaining of p16, p53, and Ki-67 was performed to compare both groups and evaluate the 13% cut-off for Ki-67, 20% for p53, and p16 intensity in various conditions aided by telepathology technology. RESULTS AND CONCLUSION Hematuria was the main clinical first presentation, with no significant difference between either group. The mean age was 61.6 years, with male predominance (52 males and 10 females). The absence of papillary histological pattern was associated with a higher stage, including detrusor muscle invasion (p = 0.000). The overall average percent of p53 immunostaining was 12.9%, revealing no significant difference between MIBC and NMIBC when a cut-off of 20% was implicated. The Ki-67 expression was correlated with higher grade and muscle invasion; however, no association was found with the other two markers' expression. The negative immunostaining of p16 was associated with low grade and NMIBC in the case of the preservation of the papillary pattern. We recommend further studies on the cut-off of widely used markers and more immunohistochemical and genetic studies on the p16(INK4A), taking into consideration the histological pattern of conventional carcinomas.
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Affiliation(s)
- Abdulkarim Hasan
- Pathology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Yasien Mohammed
- Pathology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Mostafa Basiony
- Pathology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Mehenaz Hanbazazh
- Pathology Department, Faculty of Medicine, University of Jeddah, Jeddah 23218, Saudi Arabia
| | - Abdulhadi Samman
- Pathology Department, Faculty of Medicine, University of Jeddah, Jeddah 23218, Saudi Arabia
| | - Mohamed Fayek Abdelaleem
- Preventive Medicine, Ministry of Health, Cairo 11516, Egypt
- Medixia Global LLC, Sharjah 32223, United Arab Emirates
| | - Mohamed Nasr
- Histology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Hesham Abozeid
- Urology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | | | - Mahmoud Faisal
- Urology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
- Urology Department, King Abdullah Medical City, Makkah 24246, Saudi Arabia
| | - Eslam Mohamed
- Clinical Oncology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Diaa Ashmawy
- Pathology Department, Faculty of Medicine, Al-Azhar University, Damietta 34517, Egypt
| | - Mohamed Tharwat
- Pathology Department, Faculty of Medicine, Al-Azhar University, Assiut 71524, Egypt
| | - Deaa Fekri Morsi
- Pathology Department, Faculty of Medicine, Helwan University, Helwan 11795, Egypt
| | - Abeer Said Farag
- Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo 11884, Egypt
| | - Eman Mohamed Ahmed
- Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo 11884, Egypt
| | - Noha M Aly
- Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo 11884, Egypt
| | - Hala E Abdel-Hamied
- Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo 11884, Egypt
| | - Doaa E A Salama
- Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo 11884, Egypt
- Pathology Department, School of Medicine, Badr University in Cairo (BUC), Cairo 11829, Egypt
| | - Essam Mandour
- Pathology Department, School of Medicine, Badr University in Cairo (BUC), Cairo 11829, Egypt
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