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Background: Differentiation of urothelial hyperplasia, dysplasia and carcinoma in situ (CIS) may pose diagnostic difficulties. We aim to evaluate the role of CK20, p53 and p63 in differentiation of such lesions. Methods: we evaluate these markers in 213 cases of bladder lesions (14 hyperplasia, 7 dysplasia, 5 CIS, 25 noninvasive and 162 invasive urothelial carcinoma) in a retrospective study on sections from formalin-fixed, paraffin-embedded blocks. Cytoplasmic staining considered for CK20 and nuclear staining for p53 and p63. Results: CK20 was expressed in 14 out of 14 hyperplasia (4 strong, 7 moderate, 3 weak), in 7 out of 7 dysplasia (4 strong , 3 moderate), in 5 out of 5 CIS, in 19 out of 25 noninvasive carcinoma; strong in 11 (7 low grade, 4 high grade), moderate in 7 (5 low grade, 2 high grade), and weak in 1 case of low grade, in 136 out of 162 invasive carcinoma; strong in 46 (22 grade II, 24 grade III), moderate in 71 (2 grade I, 58 grade II, 11 grade III), and weak in 19 (2 grade I, 15 grade II, 2 grade III), no expression in 2 cases of grade IV. p53 was expressed in 7 out of 14 hyperplasia (weak in all cases), in 7 out of 7 dysplasia (5 strong, 2 moderate), in 5 out of 5 CIS (strong in all cases), in 20 out of 25 noninvasive carcinoma (8 strong, 9 moderate, 3 weak), in 135 out of 162 invasive carcinoma (34 strong, 73 moderate, 28 weak). p63 was expressed in 14 out of 14 hyperplasia, in 7 out of 7 dysplasia, in 4 out of 5 CIS, in 25 out of 25 noninvasive carcinoma, and in 134 out of 162 invasive carcinoma (28 strong, 63 moderate, 43 weak). CK20 was insignificant in noninvasive and significant in invasive carcinoma, while p53 and p63 were significant in noninvasive and invasive carcinoma. Conclusion: CK20, p53 and p63 are useful in differentiation of different bladder lesions.

The Role of CK20, p53 and p63 in Differentiation of Some Urothelial Lesions of Urinary Bladder, Immunohistochemical Study