MP50-11 PARALLELS BETWEEN IMMUNOHISTOCHEMICAL CLASSIFICATION OF UPPER AND LOWER TRACT UROTHELIAL CARCINOMA USING MARKERS OF UROTHELIAL DIFFERENTIATION
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Résumé
You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma I (MP50)1 Apr 2019MP50-11 PARALLELS BETWEEN IMMUNOHISTOCHEMICAL CLASSIFICATION OF UPPER AND LOWER TRACT UROTHELIAL CARCINOMA USING MARKERS OF UROTHELIAL DIFFERENTIATION Tetsutaro Hayashi*, Kazuhiro Sentani, Kenichiro Ikeda, Keisuke Goto, Htoo Zarni Oo, Hamidreza Abdi, Shunsuke Shinmei, Shogo Inoue, Jun Teishima, Wataru Yasui, Peter C Black, and Akio Matsubara Tetsutaro Hayashi*Tetsutaro Hayashi* More articles by this author , Kazuhiro SentaniKazuhiro Sentani More articles by this author , Kenichiro IkedaKenichiro Ikeda More articles by this author , Keisuke GotoKeisuke Goto More articles by this author , Htoo Zarni OoHtoo Zarni Oo More articles by this author , Hamidreza AbdiHamidreza Abdi More articles by this author , Shunsuke ShinmeiShunsuke Shinmei More articles by this author , Shogo InoueShogo Inoue More articles by this author , Jun TeishimaJun Teishima More articles by this author , Wataru YasuiWataru Yasui More articles by this author , Peter C BlackPeter C Black More articles by this author , and Akio MatsubaraAkio Matsubara More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556426.17926.c6AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Despite a similar histologic appearance, upper tract urothelial carcinoma (UTUC) and bladder cancer (BC) have some clinico-pathologic differences. Here we compared the immunohistochemical classification of UTUC and BC using the urothelial differentiation markers Uroplakin3 (UPK3), GATA3 and Cytokeratin5/6 (CK5/6). METHODS: The study population consisted of 120 patients with pTa-4 UTUC treated with radical nephroureterectomy without neoadjuvant chemotherapy. Tissue sections from nephroureterectomy were stained for UPK3, GATA3 and CK5/6. Positive staining for these markers was defined by any cancer cell staining for UPK3, >20% of cancer cells staining for GATA3, or all layers staining for CK5/6. We compared these results to a cohort of 115 patients with muscle invasive BC. RESULTS: In normal urothelium of upper urinary tract, UPK3 expression was observed only in umbrella cells, while CK5/6 expression was detected only in the basal layer. GATA3 expression was detected in almost all layers but its expression was highest in intermediate cells. These staining patterns were the same as those in BC. UPK3, GATA3, and CK5/6 were positive in 36 (30%), 105 (88%) and 27 (22%) of all UTUC cases, respectively. Almost all UPK3+ cases (94%) and CK5/6- cases (98%) were GATA3+. We therefore classified three groups: differentiated (DG: UPK3+; n=33), intermediate (IG: UPK3- and GATA3+; n=58) and undifferentiated (UG: GATA3- or CK5/6+; n=29). The rates of DG/IG/UG were 70/57/52% in papillary morphology (P=0.32), 3/5/17% in histological variants (P=0.07), 24/33/48% in histological grade 3 (P=0.13), and 33/59/62% in pT3-4 tumors (P=0.03), respectively. Similar correlations were observed for BC. Cancer specific survival (CSS) at 10 years in DG/IG/UG was 84/75/59% (P=0.14), with prognosis in DG better than UG (P=0.034). In multivariable analysis, histological grade 3(P<0.01), but not IHC classification (P=0.25), was an independent predictor of poor prognosis. The rates of FGFR3, HER2 and EGFR expression, which are potential therapeutic targets, were 39/40/10%, 15/26/3% and 9/10/21% in DG, IG and UG, respectively. FGFR3 and HER2 expression were higher in DG and IG (P=0.0046 and 0.022) than in UG, which demonstrated the same tendency in BC. CONCLUSIONS: The expression of urothelial differentiation markers was similar in both UTUC and BC. A simple IHC classification of UTUC may enhance patient risk stratification, which could be useful in clinical practice. Source of Funding: none Hiroshima, Japan; Vancouver, Canada; Hawaii, HI; Vancouver, Canada; Ottawa, Canada; Hiroshima, Japan; Vancouver, Canada; Hiroshima, Japan© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e718-e718 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tetsutaro Hayashi* More articles by this author Kazuhiro Sentani More articles by this author Kenichiro Ikeda More articles by this author Keisuke Goto More articles by this author Htoo Zarni Oo More articles by this author Hamidreza Abdi More articles by this author Shunsuke Shinmei More articles by this author Shogo Inoue More articles by this author Jun Teishima More articles by this author Wataru Yasui More articles by this author Peter C Black More articles by this author Akio Matsubara More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,003 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».