Utility of cytokeratin 20 and Ki-67 as markers of urothelial dysplasia

Lakshmi P. Kunju, Cheryl T. Lee, James Montie, Rajal B. Shah

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)248-254
Number of pages7
JournalPathology International
Volume55
Issue number5
DOIs
StatePublished - May 1 2005
Externally publishedYes

Fingerprint

Keratin-20
Urothelium
Carcinoma in Situ
Cadherins
Monoclonal Antibodies
Staining and Labeling

Keywords

  • Carcinoma in situ
  • Cytokeratin 20
  • Immunohistochemistry
  • Ki-67
  • Urinary bladder
  • Urothelial dysplasia

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Utility of cytokeratin 20 and Ki-67 as markers of urothelial dysplasia. / Kunju, Lakshmi P.; Lee, Cheryl T.; Montie, James; Shah, Rajal B.

In: Pathology International, Vol. 55, No. 5, 01.05.2005, p. 248-254.

Research output: Contribution to journalArticle

Kunju, Lakshmi P. ; Lee, Cheryl T. ; Montie, James ; Shah, Rajal B. / Utility of cytokeratin 20 and Ki-67 as markers of urothelial dysplasia. In: Pathology International. 2005 ; Vol. 55, No. 5. pp. 248-254.
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abstract = "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.",
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AB - 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.

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