Cytokeratin 20, 34betaE12 and overexpression of HER-2/neu in urine cytology as predictors of recurrences in superficial urothelial carcinoma.

There were investigated 80 patients with superficial urothelial carcinoma of the urinary bladder (Ta and T1). All cases had a minimum follow-up of 36 months. Patients were selected in order to form two subgroups. The first group (n = 28) had no recurrence during the follow-up, and in the second (n = 52) each patient had a minimum of two recurrences. The pathologic diagnosis was performed on archive slides stained with haematoxylin-eosin. Archive smears performed at the moment of the primary diagnosis from voided urine were discolored, and used for immunocytochemistry. It was investigated the expression of cytokeratin 20, high molecular weight cytokeratin 34betaE12, and overexpression of HER-2/neu protein. Microwave antigen retrieval was performed in all immunocytochemical procedures. The working system was LSAB2 and EnVision, and diaminobenzidine was used as chromogen. The initial conventional cytology was positive for malignant cells in all cases. Cytokeratin 20 was positive in 92.85% of cases without recurrences, and in 94.23% of cases with recurrences. High molecular weight cytokeratin was expressed in 42.85% of cases without recurrence and in 63.46% of patients with recurrences. The overexpression of HER-2/neu protein was found in 7.14% of cases of the first group, and in 84.61% of cases of the second group. Our results support the idea that HER-2/neu and high molecular weight cytokeratin may be used as markers to predict recurrence in superficial urothelial carcinoma.