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Utility of cytokeratin 20 and Ki‐67 as markers of urothelial dysplasia
Author(s) -
Kunju Lakshmi P.,
Lee Cheryl T.,
Montie James,
Shah Rajal B.
Publication year - 2005
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.2005.01821.x
Subject(s) - atypia , cytokeratin , ki 67 , dysplasia , pathology , medicine , urothelium , carcinoma in situ , immunohistochemistry , proliferation marker , nuclear atypia , carcinoma , urinary bladder
Reactive urothelial atypia (RUA) can be difficult to differentiate from dysplastic urothelium. The goal was to evaluate the efficacy of cytokeratin 20 (CK20), Ki‐67 and E‐cadherin (E‐Cad) in this regard. Fifty carcinoma in situ (CIS) cases, 50 non‐neoplastic urothelia (25 normal, 25 reactive urothelial atypia (RUA)) and 17 atypia of unknown significance (AUS) cases were evaluated. All cases were stained with monoclonal antibodies against Ki‐67, CK20 and E‐Cad. All (100%) normal urothelia showed normal staining patterns. In the CIS group, 86%, 82% and 20% of cases showed abnormal expression with CK20, Ki‐67 and E‐Cad, respectively. Both Ki‐67 and CK20 were positive in 68% of cases. In the RUA group, 96%, 72% and 100% of cases showed normal expression patterns with CK20, Ki‐67 and E‐Cad, respectively. Of 28% RUA cases with increased Ki‐67, none demonstrated abnormal CK20 or E‐Cad expression. In the AUS group, 47% demonstrated abnormal CK20 and increased Ki‐67 expression, suggestive of urothelial dysplasia/CIS, 29% were negative with both, suggestive of RUA, and the remaining 24% cases could not be resolved. In summary, abnormal CK20 is a useful adjunct to morphology for confirming dysplasia. Ki‐67 by itself is a less reliable marker of dysplasia. E‐Cad is not a useful marker in this setting.