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Abstract：
Bladder urothelial carcinoma (BUC) has two pathways with distinct molecular features and prognosis, non-muscle invasive (NMI) and muscle invasive (MI) tumors. The aim is to investigate the expression of GATA3 and CK5/6 in BUC with correlation to clinicopathologic parameters, including their impact on survival beside their potential use to stratify cases into prognostic subgroups. This study included 80 cases of BUC stained immunohistochemically by GATA3 and CK5/6. The cases were divided into four groups regarding expression status of both markers (luminal, basal, mixed, and null). GATA3 percentage of expression decreased in urothelial carcinoma with squamous differentiation, MI tumors, high-grade tumors, tumors with involved lymph nodes, presence of perineural invasion, presence of bilharziasis, presence of lympho-vascular invasion, and high mitotic count. CK5/6 positivity was higher in urothelial carcinoma cases with squamous differentiation, MI tumors, and presence of perineural invasion. Pure urothelial carcinoma and NMI were in favor of luminal group (GATA3 +ve/CK5/6 -ve). Univariate analysis showed that the presence of bilharziasis was associated with shorter PFS (p = .04). GATA3 and CK5/6 could be used for the stratification of urothelial bladder carcinoma into subtypes with different characteristics. Luminal bladder cancer represents the most common type (60%) that carries favorable features. Bilharziasis-associated urothelial carcinoma carries poor outcome manifested by short PFS.
摘要：
膀胱尿路上皮癌（BUC）有两条具有不同分子特征和预后的通路，非肌肉浸润性（NMI）和肌肉浸润性（MI）肿瘤。目的是探讨BUC中GATA3和CK5/6的表达与临床病理参数的相关性。除了可能用于将病例分层为预后亚组外，还包括它们对生存率的影响。本研究包括80例BUC患者GATA3和CK5/6免疫组化染色。关于两种标志物的表达状态，将病例分为四组（管腔，基底,混合,和null）。GATA3在鳞状分化的尿路上皮癌中的表达百分比降低，MI肿瘤，高级别肿瘤，涉及淋巴结的肿瘤，存在神经周浸润，Bilharziasis的存在，淋巴血管浸润的存在，和高有丝分裂计数。CK5/6阳性在有鳞状分化的尿路上皮癌中较高，MI肿瘤，和神经周浸润的存在。单纯尿路上皮癌和NMI有利于管腔组（GATA3ve/CK5/6-ve）。单因素分析显示，血吸虫病的存在与较短的PFS相关（p=.04）。GATA3和CK5/6可用于将膀胱尿路上皮癌分层为具有不同特征的亚型。管腔膀胱癌代表了具有有利特征的最常见类型(60%)。Bilharziasis相关的尿路上皮癌的预后较差，表现为PFS短。
