PO_I_L: Pathology and Oncology I. Lectures
Ildikó Kocsmár1, Péter Riesz2, Éva Kocsmár1, Péter Nyírády2, Zsuzsa Schaff1, András Kiss1, Gábor Lotz1
1 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
2 Clinic for Urology, Semmelweis University, Budapest, Hungary
Introduction: One of the most important issues in urologic oncology is to predict the progression of non-muscle-invasive urothelial carcinomas (NMIBC) into muscle-invasive disease (MIBC). However, risk stratification based on conventional prognostic factors needs further improvement. In order to increase precision of the international risk stratification guidelines, different approaches have been developed by adding molecular markers. In our previous study we found that polysomy 17 is a prognostic factor for muscle-invasion in urine voided tumor cells.
Aims: To predict the progression of NMIBCs to muscle invasive disease by assessing the polysomy 17 and HER2 status of the tumors by using fluorescence in situ hybridization (FISH) in transurethral resection (TUR) specimens.
Method: Polysomy 17 status was assessed by FISH in transurethral resection specimens of 90 NMIBC patients, and HER2 status was determined using both IHC and FISH. HER2 assessment was performed based on the ASCO/CAP 2013 guidelines. For the FISH analysis, ZytoLight SPEC HER2/CEN 17 Dual Color Probe Kit (ZytoVision GmbH, Bremerhaven, Germany) was used. Time to progression (TTP) was determined as a time period from initial diagnosis to time of progression into muscle-invasive stages (T2 or higher stage).
Results: The median follow up was 79.5 months. Patients harboring polysomy 17 showed significantly worse prognosis when compared to patients with nonpolysomic tumor specimens (48 vs 95 months of median TTP, p = 0.001). NMIBCs with polysomy 17 had a 6.50-fold increased hazard for progression to muscle-invasive cancer (TTP; 95% confidence interval 2.01-21.02, p = 0.002). Multivariate analysis revealed polysomy as an independent prognostic factor of TTP.
Conclusion: Polysomy 17 analysis could be a useful tool in assessing disease outcome. It can help predict the progression of NMIBCs into muscle-invasive disease.
Funding: This presentation was supported by grants K128881 by the National Research, Development, and Innovation Office, and EFOP-3.6.3-VEKOP-16-2017-00009 („Development of Scientific Workshops of Medical, Health Sciences and Pharmaceutical Education”).
Semmelweis University, Doctoral School of Pathological Sciences