Clinicopathological correlation of p63 in Urothelial Carcinoma: Immunohistochemical Study

  • Rupinderjit Kaur Sri Guru Ram Das Institute of Medical sciences and Research
  • Mridu Manjari Sri Guru Ram Das Institute of Medical sciences and Research
  • Sanjay Piplani Sri Guru Ram Das Institute of Medical sciences and Research
Keywords: p63, Urothelial carcinoma, Immunohistochemistry, Grade of tumor


Background: Urothelial cancer (UCa) poses a significant medical and public health concern in most parts of the world and is defined as a pan- urothelial disease in which entire urothelium of the renal pelvis to the urethra can undergo malignant transformation.  Bladder tumors account for 90–95% of urothelial carcinomas and are the most common urinary tract malignancy. It is three times less common in females. Methods: The study was conducted on 40 cases of Urothelial Carcinoma received as biopsy specimens in a tertiary care hospital. There were 20 cases each of low grade and high grade and after grading these were subjected to p63 expression. Result: 78% of the patients were from 50-75 year age group with Male to Female ratio being 4:1. Painless hematuria was most common complaint. The size varied from 0.5 to 7.2 cm. For P63, 38 (95%) cases showed positive p63 expression. Of which 20 cases were low grade and 18 (90%) were high grade papillary urothelial carcinomas. Of P63 positive cases 36 cases showed moderate to strong staining intensity whereas two cases showed mild staining intensity. The p63 expression decreased with grade and invasion. Conclusion:   P63 immunoexpression decreases with increasing grade of tumor as well as with invasion thus showing that its expression is related with good prognosis.

Author Biographies

Rupinderjit Kaur, Sri Guru Ram Das Institute of Medical sciences and Research
Department of Pathology
Mridu Manjari, Sri Guru Ram Das Institute of Medical sciences and Research
Department of Pathology
Sanjay Piplani, Sri Guru Ram Das Institute of Medical sciences and Research
Department of Pathology


1) Roupret M, Babjuk M, Comperat E, Zigeuner R, Sylvester RJ, Burger M . European Association of Urology Guidelines on Upper Urinary Tract Urothelial Cell Carcinoma: 2015 Update. Eur Urol. 2015 Nov;68(5):868-79.
2) Grignon DJ, Lloreta J, Al Ahmadie H, Lopez-Beltran A, Amin MB, McKenney J, et al. Urothelial tumors: Infiltrating Urothelial carcinoma. In: Holger Moch, Peter A, Humphrey, Thomas M, Ulbright, Victoe ER, editors. (2016) World Health Organization Classification of Tumors. Pathology and Genetics of Tumors of the Urinary System and Male Genital Organs. 4th edition. Lyon (France): IARC Press; 2016. p.77-133.
3) Gupta P, Jain M, Kapoor R, Muruganandham K, Srivastava A, Mandhani A. Impact of age and gender on the clinicopathological characteristics of bladder cancer. Indian J Urol. 2009 Jun;25(2):207–10
4) Noone AM, Howlader N, Krapcho M, et al. SEER Cancer Statistics Review, 1975-2015, National Cancer Institute. Bethesda, MD.2017 Nov. [updated 2018 Apr cited on 2019 Oct]. Available online:
5) Pashos CL, Botteman MF, Laskin BL, Redaelli A. Bladder cancer: epidemiology, diagnosis and management. Cancer Pract. 2002 Nov-Dec; 10(6):311-22
6) Sharma S, Ksheersagar P, Sharma P. Diagnosis and treatment of bladder cancer. Am Fam Physician. 2009 Oct;80(7):717-23.
7) Heicappell R, Mattheis MV, Reinhardt M, Vosberg H, Gerharz CD, Ackermann R et al . Staging of pelvic lymph nodes in neoplasms of the bladder and prostate by positron emission tomography. Eur Urol . 1999 Dec; 36(6):582-7.
8) Cohen SM. Comparative pathology of proliferative lesions of the urinary bladder. Toxicol Pathol;30(6):663-71.
9) Orit KS, Mireia CM, Huai ST, Gladoun N, Domenech JD, Carbayo MS et al. Distinct Expression Profiles of p63 Variants during Urothelial Development and Bladder Cancer Progression. Am J Pathol. 2011 Nov;179(5):2674-5.
10) Stepan A, Margaretsu CA, Cristiana S, Raluca C. Ecaderin and p63 immunoexpression in dysplastic lesions and Urothelial carcinoma of bladder. Romanian journal of morphology and embryology. 2009 Jun;50(3):461-65.
11) Lopez-Beltran A, Venessa H, Montironi R, Cimadamore A, Raspollini MR, Cheng L. Variants and new entities of bladder cancer. Histopathology [Internet]. 2019 [cited on Jan 2020]; 74(1):77-96. Available from:
12) Elnashar TA, Noha ED, Hassab EN, Ola MN, Altef G, Wahab EL, et al. Immunohistochemical expression of p63 in urothelial carcinoma. Smj. journals. 2017 Jan;21(1):237-46.
13) Urist MJ, di Como CJ, Lu ML, Charytonowicz E, Verbel D, Cordon-Cardo C, et al. Loss of p63 expression is associated with tumor progression in bladder cancer. American Journal of Pathology. 2002 Oct;161(4):1199-1206.
14) Ahmed RA, Ibrahim Khalil EZ, Issam AA, et al. Prognostic role of epithelial mesenchymal transition markers ‘E cadherin, b catenin, ZEB1, ZEB2, and p63’ in bladder carcinoma. Wjon. 2019 December;10(6):199-217.
15) Turan T, Efilogu O, Gunaydin B, Ozkanli S, Nikerel E, Atis G. Comparative differences between T1a/b and T1e/m as substages in T1 urothelial carcinoma of bladder. Int Braz J Urol. 2018 Mar-Apr;44(2):267-72.
Original Article