The Usefulness of 4 Immunoperoxidase Stains Applied to Urinary Cytology Samples in the Pathologic Stage of Urothelial Carcinoma: A Study With Histologic Correlation

Abstract

Background: Currently, the golden rule for the diagnosis of urothelial carcinoma is biopsy and cystoscopy, unfortionally both are costly, invasive, and uncomfortable. While most urothelial cancers are noninvasive at presentation, it is necessary to find a highly sensitive, noninvasive way to diagnose in its earlier stages, Cytology with immunostaining is a noninvasive, reliable method that might play a role in detecting the earlier stages before its progression and accurate correlation with different stages of these tumors.Aim: This study aimed to reach an accurate level in the staging of urothelial carcinoma using CD44, ProExC, Laminin, and Fascin on urinary cytology.Design: We include a total of 180 urinary cytology specimens with their surgical biopsies' counterparts, the staging of the surgical specimens were done according to AJCC2017TNM classification, while their counterpart urinary samples were centrifuged and the sediment was used for H&E and immunocytochemical staining with CD44, ProExC, Laminin, and Fascin.Results: The diagnosis of Ta-stage tumors was done according to the following immunohistochemical (IHC) profile [positive (+ve) CD44, negative (−ve) proExC, −ve Laminin, and −ve Fascin] with 100% sensitivity, 100% specificity. The diagnosis of Tis stage tumors was done according to IHC profile [−ve CD44, +ve proExC, −ve Laminin, and −ve Fascin] with 100% sensitivity, 93% specificity. The diagnosis of T1 stage tumors according to IHC profile [−ve CD44, +ve proExC, +ve Laminin, and −ve Fascin] with 100% sensitivity, 97% specificity, The diagnosis of T2 and T3 stage tumors was done according to IHC profile [−ve CD44, +ve proExC, +ve Laminin and weak to moderate +ve Fascin] with 100% sensitivity, 92% specificity, while the diagnosis of T4 stage tumors according to the IHC profile [−ve CD44, +ve proExC, +ve Laminin, and intense +ve Fascin] with 100% sensitivity, 100% specificity. Conclusion:Using (CD44, ProExC, Laminin, and Fascin) on urinary cytology is a simple, reliable, and noninvasive method for the staging of urothelial carcinoma with 99% total accuracy.

High-risk human papillomavirus enhances the expression of COX-2 VEGF, EGFR, ProEx-C, and TERT proteins in human papillomavirus-related multiphenotypic sinonasal carcinoma through activation of PI3K/Akt, pRb, and TERT signalling pathways

“…Pro-Ex-C is a marker for higher-risk HPV, causing overexpression of cell cycle proteins such as mini-chromosome maintenance protein 2 (MCM2) and topoisomerase II-a (TOP2A), which are overexpressed when viral DNA integrates into the host genome, leading to aberrant S-phase induction [52]. In many epithelial tumours, such as the cervix, endometrium, bladder, thyroid, and oesophagus, the Pro-Ex-C marker is an immunohistochemical cocktail including antibodies against both TOP2A and MCM2 proteins that detect early dysplastic changes, premalignant lesions, and prognostic outcomes [52][53][54][55][56][57].…”

“…Immunohistochemistry was performed by using anti VEGF, COX-2, EGFR, ProEx-C and TERT antibodies [21][22][23][24][25]. Vascular endothelial growth factor in a 1/20 dilution (a mouse monoclonal antibody (H11) Catalogue # MA5-13182, Invitrogen, Thermo Fisher Scientific, USA), COX-2 a rabbit monoclonal anti-COX-2 antibody (diluted 1: 50; BIOCARE MEDICAL, USA), EGFR in 2 µg/ml dilution (a mouse monoclonal antibody (JH121) Catalogue # MA5-13070, Invitrogen, Thermo Fisher Scientific, USA) ProExC (prediluted, clone MCM2 26H6.19, MCM2 27C5.6, TOP2A SWT3D1; TriPath Imaging Inc, Burlington, NC), TERT, anti-telomerase catalytic subunit (RABBIT) antibody-600-401-252S (Rockland Immunochemicals, Inc., Limerick, PA, USA), muscle-specific actin (clone HHF35; Ventana), calponin (clone CALP; Dako), and S100 (clone 4C4.9; Ventana [26][27][28][29][30].…”

PYCR1, BANF1, and STARD8 Expression in Gastric Carcinoma: A Clinicopathologic, Prognostic, and Immunohistochemical Study

“…12,13 Antigen retrieval was achieved with 10 mmol/l sodium citrate for 24 minutes. The primary antibody was incubated for 16 minutes using rabbit monoclonal antibodies versus primary antibodies against rabbit monoclonal (PYCR1, 1:2000; Proteintech, [14][15][16][17] ) anti-BANF1 antibody [18][19][20][21] (1:100) with mouse anti-STARD8 (1:1,000; [22][23][24][25] Abcam) overnight at 4°C. Tissues were fixed in formalin 10%, and an automated method was used.…”

Role of Neoadjuvant Chemotherapy Followed by Interval Cyto-Reductive Surgery in Reducing Progression and Recurrence of Patients with Advanced Endometrial Cancer

“…The sections were then washed again, and the immunoreactivity was identified using (3,3′-Diaminobenzidine) DAB staining and hematoxylin counterstaining. Positive immunoreactivity was shown by brown staining (25)(26)(27)(28) .…”