Güncel Patoloji Dergisi 2026, Cilt 10, Sayı 2
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Prognostic Evaluation of an Immunohistochemical Panel in Non-Invasive Papillary Urothelial Carcinoma of the Bladder
Sumru ÇAĞAPTAY 1, Muhammed Selçuk ÖZER 2, Hülya ELLİDOKUZ 3, Volkan ŞEN 2, Kutsal YÖRÜKOĞLU 1
1 Dokuz Eylül Üniversitesi Tıp Fakültesi, Tıbbi Patoloji Anabilim Dalı, İzmir, Türkiye
2 Dokuz Eylül Üniversitesi Tıp Fakültesi, Üroloji Anabilim Dalı, İzmir, Türkiye
3 Dokuz Eylül Üniversitesi Tıp Fakültesi, Prevantif Onkoloji Anabilim Dalı, İzmir, Türkiye
DOI : 10.5146/jcpath.2026.713 Objective: Bladder carcinomas are broadly categorized into non-muscle-invasive and muscle-invasive bladder carcinomas. Invasive urothelial carcinomas have been classified into prognostic subgroups based on molecular studies. The aim of this study was to evaluate the applicability of the current immunohistochemistry-based molecular classification in non-invasive urothelial carcinomas, to identify the optimal markers for establishing a practical and cost-effective panel for tumor subtyping, and to assess the utility of these markers in predicting prognosis. Material and Methods: In this study, 184 patients diagnosed with pTa stage urothelial carcinoma between 2017 and 2022 were retrospectively re-evaluated. Clinicopathological parameters, including age, gender, histological grade, recurrence, and progression, were statistically analyzed in relation to the immunohistochemical expression of Ki-67 (proliferative activity), p53, cytokeratin 5/6, CD44, GATA3, and cytokeratin 20. Results: A statistically significant correlation was observed between high tumor grade and cytokeratin 20 positivity, high Ki-67 proliferation index, and mutant-pattern p53 expression (p<0.001). A significant association was found between high tumor grade and the luminal subgroup, as well as between low tumor grade and the null/basal subgroups (p=0.002). Furthermore, a strong correlation was identified between the null/basal subgroups and a low Ki-67 proliferation index, and between the luminal subgroup and a high Ki-67 proliferation index (p<0.001). The relationship between tumor recurrence and a high Ki-67 proliferation index was statistically significant in univariate analysis (p=0.013). In multivariate analysis, a high Ki-67 proliferation index was identified as an independent poor prognostic factor for recurrence, while a high tumor grade served as an independent poor prognostic factor for progression. Conclusion: The utility of immunohistochemistry-based molecular classification in predicting prognosis for pTa urothelial carcinomas may be limited with current marker panels; therefore, multicenter studies involving larger patient cohorts are warranted. Anahtar Kelimeler : Urothelial carcinoma, Immunohistochemistry, Molecular typing, Prognosis