p53 and cytokeratin 20 immune marker expression as dual marker in papillary lesions of urinary bladder

Abstract

Background: The classification and grading of papillary urothelial neoplasm has been a long-standing subject of controversy and various immunohistochemistry markers have been studied, out of which p53 and cytokeratin 20 (CK20) are emerging as useful indicators for neoplastic changes and prognosis in urothelial proliferations. Aim and Objectives: To determine the expression status of p53 and CK20 immune markers in papillary lesions of urinary bladder. Material and Methods: This was a prospective study of 2 years. All lesions favouring papillary lesions were included. Metastatic lesions and recurrent papillary lesions were excluded from the study. For statistical analysis, IBM SPSS-21.1 version software was used and the levels of significance were calculated using Chi-square test and Fisher's exact test. Results: A total of 59 papillary lesions of urinary bladder were studied. Males were affected more than females. The commonest lesion noted was high grade non-invasive papillary carcinoma. The combined usage of CK20 and p53 as a dual immune markers showed statistical significance (p = 0.046) in differentiating papillary lesions. Conclusions: The present study concluded that differentiating papillary lesions of urothelium, depending on morphology is challenging and thus staining for CK20 and p53 may be helpful in differentiating the lesions.

Keywords

• invasive papillary carcinoma
• immunohistochemistry
• bladder biopsy