Placental proteins in high-grade urothelial neoplasms. An immunohistochemical study of human chorionic gonadotropin, human placental lactogen, and pregnancy-specific beta-1-glycoprotein.
We examined the presence of human chorionic gonadotropin (HCG) in 16 low-grade and 47 high-grade urothelial neoplasms, including two cases with trophoblastic-like differentiation. In HCG-positive tumors, the presence of human placental lactogen (HPL) and pregnancy-specific beta-1-glycoprotein (SP-1) also was assessed. HCG immunoreactive cells were found in nine of the 47 high-grade tumors (19%), whereas none of the low-grade tumors were positive for HCG. This hormone was predominantly detected in the most undifferentiated and pleomorphic areas; however, HCG-positive cells also were found in areas of carcinoma in situ and well-differentiated transitional cell carcinoma in two cases. The serum HCG level was increased in two of the four cases studied. HPL and SP-1 immunoreactive cells were observed in seven and five cases, respectively, and it was found that tumors positive for SP-1 also were positive for HPL. Five tumors, including the two with trophoblastic differentiation, contained the three placental proteins. The HPL and SP-1 immunostained cells were usually found in the same areas of the tumor that were positive for HCG, but there was always a lower number of HPL and SP-1 immunoreactive cells than HCG immunoreactive cells. In one case, HPL and SP-1 could be found in areas of well-differentiated transitional cell carcinoma. These findings suggest that the morphologic and functional trophoblastic differentiation in urothelial carcinomas is a progressive phenomenon evolving from transitional cell carcinomas.
Campo
E
E
Department of Pathology, Hospital Clínico y Provincial de Barcelona, Spain.
Algaba
F
F
Palacin
A
A
Germa
R
R
Sole-Balcells
F J
FJ
Cardesa
A
A
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000032:analysis; D002295:Carcinoma, Transitional Cell / Q000032:analysis; D002822:Choriocarcinoma / Q000032:analysis; D006063:Chorionic Gonadotropin / Q000032:analysis; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007680:Kidney Neoplasms / Q000032:analysis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010928:Placental Lactogen / Q000032:analysis; D011257:Pregnancy Proteins / Q000032:analysis*; D011268:Pregnancy-Specific beta 1-Glycoproteins / Q000032:analysis; D001749:Urinary Bladder Neoplasms / Q000032:analysis* / Q000473:pathology
D006063:Chorionic Gonadotropin; D011257:Pregnancy Proteins; D011268:Pregnancy-Specific beta 1-Glycoproteins; D010928:Placental Lactogen