Virchows Archiv

, Volume 458, Issue 3, pp 301–312

Different immunohistochemical and ultrastructural phenotypes of squamous differentiation in bladder cancer

  • Nadine T. Gaisa
  • Till Braunschweig
  • Nina Reimer
  • Jörg Bornemann
  • Elke Eltze
  • Sabine Siegert
  • Marieta Toma
  • Luigi Villa
  • Arndt Hartmann
  • Ruth Knuechel
Original Article

DOI: 10.1007/s00428-010-1017-2

Cite this article as:
Gaisa, N.T., Braunschweig, T., Reimer, N. et al. Virchows Arch (2011) 458: 301. doi:10.1007/s00428-010-1017-2

Abstract

Besides worse prognosis of bladder cancer with squamous differentiation (pure squamous cell carcinoma (SCC) or mixed urothelial carcinoma (UC/SCC)), high-grade non-keratinising squamous differentiation is difficult to identify in haematoxylin–eosin stainings. This study aims to validate routine immunohistochemical markers for squamous differentiation in a larger cohort of patients. Tissue microarrays of 89 pure SCCs and mixed UC/SCCs, 66 urothelial carcinomas (UC), precursor lesions and normal urothelium were stained for cytokeratin (CK) 5/6, CK 5/14, CK 7, CK 20 and uroplakin III. Electron microscopy was performed to confirm the differentiation. Pure SCCs displayed staining throughout the epithelium for CK 5/6 (76.6% (36/47)) and CK 5/14 (95.8% (46/48)), focal staining for CK 7 (28.9% (13/45)) and no staining for CK 20 and uroplakin III (both 0% (0/48)). UCs exhibited a basal or diffuse staining for CK 5/6 (30.2% (16/53)) and CK 5/14 (57.1% (32/56)), focal positivity for CK 7 (83.6% (46/55)), CK 20 (50.9% (29/57)) and uroplakin III (21.8% (12/55)). Each marker discriminated SCC and UC significantly (p < 0.01). A third subgroup rarely showed full epithelial staining for CK 5/6 (14.3% (1/7)) and CK 5/14 (28.6% (2/7)), focal staining for CK 7 (85.7% (6/7)) and no staining for CK 20 and uroplakin III (both 0% (0/7)). Electron microscopy could prove both, SCC and UC characteristics, revealing a transient type. A staining pattern with CK 5/6- and CK 5/14-positivity plus CK 20- and uroplakin III-negativity identified squamous differentiation in bladder tumours and revealed a third type of squamous transdifferentiation.

Keywords

Squamous cell carcinomaBladderCK 5/6CK 5/14CK 20Uroplakin

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Nadine T. Gaisa
    • 1
  • Till Braunschweig
    • 1
  • Nina Reimer
    • 1
  • Jörg Bornemann
    • 2
  • Elke Eltze
    • 3
  • Sabine Siegert
    • 4
  • Marieta Toma
    • 5
  • Luigi Villa
    • 6
  • Arndt Hartmann
    • 7
  • Ruth Knuechel
    • 1
  1. 1.Institute of PathologyRWTH Aachen UniversityAachenGermany
  2. 2.Electron Microscopic FacilityRWTH Aachen UniversityAachenGermany
  3. 3.Institute of Pathology Saarbruecken-RastpfuhlSaarbrueckenGermany
  4. 4.Institute of Pathology LMU MunichMunichGermany
  5. 5.Institute of PathologyUniversity DresdenDresdenGermany
  6. 6.Division of NephrologyUniversity Hospital RWTH AachenAachenGermany
  7. 7.Institute of PathologyUniversity Hospital ErlangenErlangenGermany