Evaluation of fascin-1 expression as a marker of invasion in urothelial carcinomas.
BACKGROUND
Prognostication and therapeutic evaluation of urothelial carcinomas significantly depends on the depth of invasion. The assessment of invasion on routine histopathological sections may be difficult in some cases. Fascin is an actin-bundling protein involved in tumor cell migration with enhanced expression associated with invasive tumors. The data available on fascin-1 expression in urothelial carcinoma however is limited. To characterize fascin-1 expression in urothelial neoplasms and its correlation with invasiveness in urothelial carcinomas.


METHODS
A descriptive study design wherein fascin-1 immunoreactivity was studied in 126 urothelial neoplasms using monoclonal antibody against fascin by immunohistochemistry. 52/126 (41.26%) were low grade carcinomas (48/52 stage pTa and 4/52 stage pT1), 46/126 (36.5%) high grade carcinomas (13/46 stage pTa, 8/46 stage pT1 and 25/46 stage pT2), 02/126 carcinoma-in-situ, 03/126 papilloma, 12/126 papillary urothelial neoplasm of uncertain malignant potential and 11/126 were other variants of urothelial carcinomas. Fascin-1 cytoplasmic immunoreactivity was assessed semiquantitatively in terms of extent, intensity and a combined immunoreactivity score. Correlation between immunoreactivity scores and invasiveness was evaluated using Pearson's chi-square (χ2) and Nonparametric Spearman rho (ρ) correlation coefficient two tailed.


RESULTS
The scores for intensity, extent and combined immunoreactivity were significantly higher in invasive carcinomas. In addition, strong staining was observed exclusively in invasive carcinomas. None of the pTa tumors demonstrated intense staining, including those categorized as high grade carcinomas.


CONCLUSIONS
Fascin-1 overexpression may be used as a marker in urothelial carcinomas where it is morphologically difficult to determine the status of invasion.
Graded Specialist (Pathology), Military Hospital Yol, C/o 56 APO, India.
Arun
A
Sharma
Associate Professor, Dept of Pathology, Armed Forces Medical College, Pune 411040, India.
Sonia
S
Badwal
Consultant (Pathology & Oncopath), Army Hospital (R&R), Delhi 10, India.
Vibha
V
Dutta
Senior Advisor (Pathology), Command Hospital (Eastern Command), Kolkata, India.
Atoshi
A
Basu
Fascin; Immunoreactivity scores; Urothelial carcinoma