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Micropapillary urothelial carcinoma of urinary bladder displays immunophenotypic features of luminal and p53-like subtypes and is not a variant of adenocarcinoma.
Urol Oncol. 2020 05; 38(5):449-458.UO

Abstract

OBJECTIVES

Micropapillary urothelial carcinoma of the urinary bladder (MPUC) is a rare variant of urothelial carcinoma which has aggressive clinical characteristics. The objective is to investigate the molecular subtypes of MPUC and the impact to the clinical outcome and determine whether MPUC represents a variant of adenocarcinoma.

MATERIALS AND METHODS

We evaluated surrogate immunohistochemical markers of luminal, basal, and p53-like subtypes and correlated with prognosis and the expression of markers related to bladder adenocarcinoma and glandular differentiation in 56 cases of MPUC (10 cases of transurethral resection and 46 cases of radical cystectomy). Biomarker expression in co-existing conventional urothelial carcinoma was also analyzed. Cox regression analysis was performed to study the impact of molecular subtype on the clinical outcome.

RESULTS

Thirty-four cases (61%) met criteria for the luminal subtype. Twenty-two cases (39%) displayed a p53-like subtype. In contrast, 40/56 (71%) cases of coexisting conventional urothelial carcinoma were classified as luminal subtype and 16/56 (29%) cases were designated as p53-like subtype. There was no significant survival difference between luminal subtype and p53-like subtype. CDX2, villin, and cadherin 17 were negative in all cases. MUC1 was strongly and diffusely expressed in the stroma-facing surface of MPUC tumor cells in all the cases.

CONCLUSIONS

Our findings suggest that MPUC possesses characteristics of luminal and p53-like subtypes, and does not harbor phenotypic features of the basal subtype. There is no significant difference in the prognosis between luminal and p53-like subtype MPUC. MPUC is not a variant of adenocarcinoma and does not represent a form of glandular differentiation, in contrast to other organ sites.

Authors+Show Affiliations

Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN.Department of Urology, Indiana University School of Medicine, Indianapolis, IN.Department of Pathology and Laboratory Medicine and Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI; Department of Pathology and Laboratory Medicine, Wayne State University School of Medicine, Detroit, MI.Department of Urology, Indiana University School of Medicine, Indianapolis, IN.Department of Medicine, Indiana University School of Medicine, Indianapolis, IN.Department of Urology, Indiana University School of Medicine, Indianapolis, IN.Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN.Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN.Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN.Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN.Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN.Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN.Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN; Department of Urology, Indiana University School of Medicine, Indianapolis, IN. Electronic address: liang_cheng@yahoo.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31740332

Citation

Yang, Yu, et al. "Micropapillary Urothelial Carcinoma of Urinary Bladder Displays Immunophenotypic Features of Luminal and P53-like Subtypes and Is Not a Variant of Adenocarcinoma." Urologic Oncology, vol. 38, no. 5, 2020, pp. 449-458.
Yang Y, Kaimakliotis HZ, Williamson SR, et al. Micropapillary urothelial carcinoma of urinary bladder displays immunophenotypic features of luminal and p53-like subtypes and is not a variant of adenocarcinoma. Urol Oncol. 2020;38(5):449-458.
Yang, Y., Kaimakliotis, H. Z., Williamson, S. R., Koch, M. O., Huang, K., Barboza, M. P., Zhang, S., Wang, M., Idrees, M. T., Grignon, D. J., Eble, J. N., Baldridge, L. A., & Cheng, L. (2020). Micropapillary urothelial carcinoma of urinary bladder displays immunophenotypic features of luminal and p53-like subtypes and is not a variant of adenocarcinoma. Urologic Oncology, 38(5), 449-458. https://doi.org/10.1016/j.urolonc.2019.10.013
Yang Y, et al. Micropapillary Urothelial Carcinoma of Urinary Bladder Displays Immunophenotypic Features of Luminal and P53-like Subtypes and Is Not a Variant of Adenocarcinoma. Urol Oncol. 2020;38(5):449-458. PubMed PMID: 31740332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Micropapillary urothelial carcinoma of urinary bladder displays immunophenotypic features of luminal and p53-like subtypes and is not a variant of adenocarcinoma. AU - Yang,Yu, AU - Kaimakliotis,Hristos Z, AU - Williamson,Sean R, AU - Koch,Michael O, AU - Huang,Kun, AU - Barboza,Marcelo P, AU - Zhang,Shaobo, AU - Wang,Mingsheng, AU - Idrees,Muhammad T, AU - Grignon,David J, AU - Eble,John N, AU - Baldridge,Lee Ann, AU - Cheng,Liang, Y1 - 2019/11/15/ PY - 2019/08/14/received PY - 2019/10/15/revised PY - 2019/10/23/accepted PY - 2019/11/20/pubmed PY - 2019/11/20/medline PY - 2019/11/20/entrez KW - Basal/luminal subtype KW - Micropapillary variant KW - Molecular classification KW - Molecular genetics KW - Urinary bladder SP - 449 EP - 458 JF - Urologic oncology JO - Urol. Oncol. VL - 38 IS - 5 N2 - OBJECTIVES: Micropapillary urothelial carcinoma of the urinary bladder (MPUC) is a rare variant of urothelial carcinoma which has aggressive clinical characteristics. The objective is to investigate the molecular subtypes of MPUC and the impact to the clinical outcome and determine whether MPUC represents a variant of adenocarcinoma. MATERIALS AND METHODS: We evaluated surrogate immunohistochemical markers of luminal, basal, and p53-like subtypes and correlated with prognosis and the expression of markers related to bladder adenocarcinoma and glandular differentiation in 56 cases of MPUC (10 cases of transurethral resection and 46 cases of radical cystectomy). Biomarker expression in co-existing conventional urothelial carcinoma was also analyzed. Cox regression analysis was performed to study the impact of molecular subtype on the clinical outcome. RESULTS: Thirty-four cases (61%) met criteria for the luminal subtype. Twenty-two cases (39%) displayed a p53-like subtype. In contrast, 40/56 (71%) cases of coexisting conventional urothelial carcinoma were classified as luminal subtype and 16/56 (29%) cases were designated as p53-like subtype. There was no significant survival difference between luminal subtype and p53-like subtype. CDX2, villin, and cadherin 17 were negative in all cases. MUC1 was strongly and diffusely expressed in the stroma-facing surface of MPUC tumor cells in all the cases. CONCLUSIONS: Our findings suggest that MPUC possesses characteristics of luminal and p53-like subtypes, and does not harbor phenotypic features of the basal subtype. There is no significant difference in the prognosis between luminal and p53-like subtype MPUC. MPUC is not a variant of adenocarcinoma and does not represent a form of glandular differentiation, in contrast to other organ sites. SN - 1873-2496 UR - https://www.unboundmedicine.com/medline/citation/31740332/Micropapillary_urothelial_carcinoma_of_urinary_bladder_displays_immunophenotypic_features_of_luminal_and_p53_like_subtypes_and_is_not_a_variant_of_adenocarcinoma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-1439(19)30419-3 DB - PRIME DP - Unbound Medicine ER -
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