Prognostic Value of c-Myc Immunohistochemical Expression in Muscle Invasive Urothelial Carcinoma of the Urinary Bladder: A Retrospective Study

Abstract

Objective: This study aimed to investigate the immunohistochemical expression of c-Myc in muscle invasive urothelial carcinoma (MIUC) of the urinary bladder and to evaluate the correlation of c-Myc expression with different clinicopathological parameters and outcome, including a relatively new histopathological tumor characteristic that is the growth pattern of tumor invasion. Methods: A total of 66 formalin-fixed and paraffin-embedded sections of MIUC obtained from radical cystectomy specimens were enrolled. The sections were stained with c-Myc antibody using immunohistochemistry technique. Results: Tumor cells showed variability in nuclear c-Myc expression according to the growth pattern of invasion. The median H-score of nuclear expression of infiltrative pattern was significantly higher than that of non-infiltrative pattern (p<0.001). Nuclear expression of c-Myc in tumor tissue had a significant association with poor prognostic factors (sarcomatoid variant (p<0.001), perineural invasion (p=0.037), lymphovascular invasion (p<0.001), lymph node metastasis (p<0.001), distant metastasis (p=0.042) and advanced stage grouping (p=0.001). Kaplan Meier survival analysis demonstrated that c-Myc expression could not be significantly correlated with overall survival or disease free survival rates. Conclusion: Nuclear c-Myc seems to have a prominent role in epithelial to mesenchymal transition with consequential in tumor progression and metastasis, while it is not as much useful to predict the clinical behavior of patients with MIUC.

CEA (CEACAM5) expression is common in muscle‐invasive urothelial carcinoma of the bladder but unrelated to the disease course

“…28 Given the lack of prognostic impact of grade in muscle‐invasive urothelial carcinoma, it was recommended to avoid grading in these tumours in the WHO classification of genitourinary carcinomas since 2004. 29 Considering that molecular features with an unequivocal functional role in cancer cells such as p53 alterations, 30 HER2 overexpression, 31 and MYC 32 have also failed to be prognostic in most studies on pT2–4 bladder cancer demonstrates that the absence of a prognostic relevance of the expression of a specific gene in urothelial cancer does rule out a relevant role in tumour biology.…”

Association between c-Myc Expression with Clinicopathological Features in T And NK Cell Lymphomas

“…However, Mohammed et al, (2019) showed that, c-Myc and BCL2 IHCs protein over expressions were comparable with RT-PCR c-Myc and BCL2 genes arrangements in understanding the DLBCL prognostication. Another study on c-Myc protein expression in bladder carcinoma showed it could predict the clinical behaviour of the disease (Elwy et al, 2019). IHC of c-Myc are now emerging as a favourable alternative as it is a cheaper and easier technique which can be used to study the effects of this protein in disease behaviour.…”

Molecular Detection of Genetic Susceptibility to Bladder Cancer in Egyptian Patients

“…Histoscore (H-score) system was applied to quantify c-Myc expression with a range of 0-300. H-score was achieved by semi-quantitative assessment of both the intensity, classified as negative (0), weak (1+), moderate (2+) and strong (3+) and the percentage of positive cells according to the following formula (Elwy et al, 2019).…”