“…In the study by Queipo et al [ 39 ], immunohistochemical subtyping was performed according to the Lund classification scheme, and cases that were GATA3 and CK5/6 negative were assigned to the Mesenchymal-like and Neuroendocrine groups based on the presence or absence of sarcomatoid or neuroendocrine features histologically [ 39 ]. According to the consensus classification by Kamoun et al [ 20 ], most Lund Mesenchymal-like cases belong to the stroma-rich subtype, while some belong to the Ba/Sq type.…”
Section: Discussionmentioning
confidence: 99%
“…Similar to the well-established approach in breast cancer subtyping, IHC has the potential to be the method of choice in MIBC subtyping. Previously published IHC classification schemes have thus far used many antibodies, which are often not in routine clinical use [15,33,[37][38][39]. The present study aimed to develop a simple and easily reproducible IHC method for subtyping the three major subtypes of urothelial carcinoma and to test it for prognostic relevance in a retrospective series.…”
The choice of therapy for muscle-invasive bladder cancer (MIBC) could be influenced by the tumor’s molecular subtype. Currently, well-defined consensus subtypes are based on tumor microarray mRNA data. Clearly defined and easy-to-use surrogate molecular subtypes, based on immunohistochemistry (IHC) performed on whole slides, are needed to make subtyping cost-effective and useful in routine work and future research. To aid in the development of a simple immunohistochemical classifier, a retrospective single-center series of 92 cases of localized bladder cancer was identified. Routine IHC for GATA3, cytokeratins 5 and 6 (CK5/6), and p16 was performed on whole tissue blocks containing muscle-invasive disease. Electronic medical records were retrieved and searched for clinical variables, treatment, and survival data. The mean age was 69.6 years, and 73% were males. Conservative treatment was used in 55% of cases, while cystectomy with chemotherapy was used in 45%. GATA3 and CK5/6 expression divided cases into broad luminal and basal subtypes, respectively, while p16 expression was used to subclassify luminal cases into luminal papillary and luminal unstable types according to the consensus molecular classification. When subtyped in this way, GATA3 and CK5/6 negative cases showed worse overall survival. Molecular subtyping of MIBC on whole slides containing muscle-invasive tumor using only three commonly used, consensus-based antibodies, is a feasible and cost-effective method for detecting subtypes of invasive bladder cancer. Future work combining morphological analysis and IHC is needed to fully translate the consensus molecular classification into a comprehensive, cost-effective subtyping strategy.
“…In the study by Queipo et al [ 39 ], immunohistochemical subtyping was performed according to the Lund classification scheme, and cases that were GATA3 and CK5/6 negative were assigned to the Mesenchymal-like and Neuroendocrine groups based on the presence or absence of sarcomatoid or neuroendocrine features histologically [ 39 ]. According to the consensus classification by Kamoun et al [ 20 ], most Lund Mesenchymal-like cases belong to the stroma-rich subtype, while some belong to the Ba/Sq type.…”
Section: Discussionmentioning
confidence: 99%
“…Similar to the well-established approach in breast cancer subtyping, IHC has the potential to be the method of choice in MIBC subtyping. Previously published IHC classification schemes have thus far used many antibodies, which are often not in routine clinical use [15,33,[37][38][39]. The present study aimed to develop a simple and easily reproducible IHC method for subtyping the three major subtypes of urothelial carcinoma and to test it for prognostic relevance in a retrospective series.…”
The choice of therapy for muscle-invasive bladder cancer (MIBC) could be influenced by the tumor’s molecular subtype. Currently, well-defined consensus subtypes are based on tumor microarray mRNA data. Clearly defined and easy-to-use surrogate molecular subtypes, based on immunohistochemistry (IHC) performed on whole slides, are needed to make subtyping cost-effective and useful in routine work and future research. To aid in the development of a simple immunohistochemical classifier, a retrospective single-center series of 92 cases of localized bladder cancer was identified. Routine IHC for GATA3, cytokeratins 5 and 6 (CK5/6), and p16 was performed on whole tissue blocks containing muscle-invasive disease. Electronic medical records were retrieved and searched for clinical variables, treatment, and survival data. The mean age was 69.6 years, and 73% were males. Conservative treatment was used in 55% of cases, while cystectomy with chemotherapy was used in 45%. GATA3 and CK5/6 expression divided cases into broad luminal and basal subtypes, respectively, while p16 expression was used to subclassify luminal cases into luminal papillary and luminal unstable types according to the consensus molecular classification. When subtyped in this way, GATA3 and CK5/6 negative cases showed worse overall survival. Molecular subtyping of MIBC on whole slides containing muscle-invasive tumor using only three commonly used, consensus-based antibodies, is a feasible and cost-effective method for detecting subtypes of invasive bladder cancer. Future work combining morphological analysis and IHC is needed to fully translate the consensus molecular classification into a comprehensive, cost-effective subtyping strategy.
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