Significance of Her2/Neu, C-kit and P63 Immunohistochemical Expression in Bladder Urothelial Carcinoma

Background Urothelial carcinoma (UC) is a devastating disease with high mortality rate. Patients at same grade/ stage can have different outcomes, which necessitate better prognostic markers for estimating the risk of progression. Aim To assess the impact of Her2 /Neu, C-kit, and P63 on carcinogenesis and behavior of UC. Methods Her2/Neu, C-kit, and P63 were assessed by immunohistochemistry in 60 cases of UC, and correlated with clinicopathological parameters. Results Her2/Neu was expressed in 40 % of cases. It showed positive expression in 33.3 % of low grade and 44.4 % of high grade UC. It was expressed in 14.3 %, 47.8 % of non-invasive and invasive UC respectively, with significant association with grade and stage (p=0.023, less than0.001 respectively). C-kit was expressed in 46.7 % of cases with significant association with both grade and stage (p less than0.00). P63 was expressed in all low grade and in 66.7 % of high-grade UC cases, it was expressed in all non-invasive and in 73.3 % of invasive cases with significant association with grade and stage (p =0.001, 0.001 respectively) (decreased expression with increasing grade /stage). A significant positive correlation was detected between Her2/Neu, C-kit ( =+0.35, p=0.001), while a significant strong inverse correlation was observed between P63 and both Her2/Neu ( =-0.641, pless than0.001), and C-kit ( = -0.558, pless than0.001). Conclusion Her2Neu, C-kit overexpression and loss of P63 are important players in carcinogenesis of UC and could be considered as poor prognostic parameters. Patients must be examined for Her2/Neu and C-kit status for selection of suitable candidates for adjuvant targeted therapies.