A 5 Year Analysis of Different Types of Urothelial Malignancies with Special Reference to The Expression Of EGFR in These Tumours
Abstract
Background: Urothelial neoplasms are a heterogenous group of neoplasms with high propensity for recurrence. EGFR is a novel and potential biological marker for predicting the prognosis of urothelial malignancies. This study highlights the diagnostic and prognostic usefulness of EGFR as a phenotypic marker in urothelial malignancies. Thus, it warrants for anti-tumour therapy and prevention of recurrence of urothelial cancers by anti-EGFR therapy. Methods: Current study includes 500 cases of urothelial tumours received in a major tertiary center in South Kerala. Based on the histopathological features these tumours were classified according to the WHO-2016 criteria. Proportion in each class of urothelial tumours during the study period was calculated. In addition to that, we also studied relation between EGFR expression and tumour grade and recurrence. Inclusion criteria: All consecutive cystoscopy biopsies, transurethral resection of bladder tumour (TURBT) and radical cystectomy specimens histologically diagnosed as urothelial malignancies of bladder. Exclusion criteria: All benign urothelial cases. Result: Out of the 500 cases of urothelial malignancies included in the study, the non-invasive papillary urothelial carcinoma, low grade constituted the major part, the second being invasive urothelial carcinoma, high grade, followed by noninvasive urothelial carcinoma, high grade. A strong expression of EGFR was found to be significantly associated with higher tumour grade (P = 0.001) and recurrence (P = 0.010). Conclusion: Histopathology supported by immunohistochemistry is a helpful tool in subtyping the various urothelial malignancies. EGFR can be considered as an adverse prognostic factor, the expression of which increases with tumour grade and stage. EGFR positivity may favor the use of targeted therapy in urothelial malignancies.References
Mark Hurwitz, Philippe E. Spiess, Jorge A. Garcia. Urothelial and Kidney Cancers. Oncology 2016;10(12):56-6
Mellon K, Wright C, Kelly P, Horne CH, Neal DE. Long-term outcome related to epidermal growth factor receptor status in bladder cancer. Journal of Urology (1995); 153):919-25.
Shariat, S.F., et al. Gender differences in radical nephroureterectomy for upper tract urothelial carcinoma. World Journal of Urology 2011; 29(2): 481-4.
Karbakhsh M, Dabbagh N, Tabibi A, Shabani A, Akhavizadegan H. Age at diagnosis in bladder cancer: Does opium addiction play a role. Asian Pacific Journal of Cancer Prevention 2013; 14 (8): 4723-5.
Atif Ali Hashmi. Prognostic significance of epidermal growth factor receptor (EGFR) over expression in urothelial carcinoma of urinary bladder. BMC Urology2018; 18(1): 59-65
Laishram RS, Kipgen P, Laishram S, Khuraijam S, Sharma DC. Urothelial tumours of the urinary bladder in Manipur: A histopathological perspective. Asian Pacific Journal of Cancer Prevention 2012; 13(6): 2477-9.
Lughezzani, G., et al. Gender-related differences in patients with stage I to III upper tract urothelial carcinoma: results from the Surveillance, Epidemiology, and End Results database. Urology, 2010; 75(1): 321-6.
Seisen, T., et al. A Systematic Review and Meta-analysis of Clinicopathologic Factors Linked to Intravesical Recurrence After Radical Nephroureterectomy to Treat Upper Tract UrothelialCarcinoma. EurUrol, 201; 67(1): 1122-5.
Holmang S, Andius P, Hedelin H, Wester K, Busch C, Johansson SL. Stage progression in Ta papillary urothelial tumours: relationship to grade, immunohistochemical expression of tumour markers, mitotic frequency and DNA ploidy. American Journal of Pathology 2001; 165(4): 1124-30.
Munoz, J.J., et al. Upper tract urothelial neoplasms: incidence and survival during the last 2decades. Journal of Urology 2000; 164(2): 1523-5.
Chang SS, Hassan JM, Cookson MS, Wells N, Smith Jr JA. Delaying radical cystectomy for muscle invasive bladder cancer results in worse pathological stage. Journal of Urology 2003;170(41):1085–7.
Herr HW. A proposed simplified staging system of invasive bladder tumours. Urology International 1993; 50(15):17–20.
Kumar M, Yelikar B. Spectrum of lesions in cystoscopic bladder biopsies: A histopathological study. Journal of clinical and diagnostic research 2013; 7(8): 1609-11.16.
Dayalu S.L. Naik, Shashi Sharma, Amitabha Ray, Suresh Hedau. Epidermal Growth Factor Receptor Expression in Bladder Cancer. Indian Journal of Pathology2011; 27(2):208-214.
Neal DE, Sharples L, Smith K, et al. The epidermal growth factor receptor and the prognosis of bladder cancer. Cancer. 1990; 65(4):1619–1625.
Nicholson RI, Gee JMW, Harper ME EGFR. Cancer prognosis. European Journal of Cancer 2001;37(1):9–15.
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