A clinico-immunohistopathological study of urothelial neoplasms with an expression of HER2/Neu and Ki-67 in malignant lesions presenting to a tertiary centre

HER2/neu is associated with increased tumor grade, and Ki-67 is related to tumor recurrence and stage progression. This study aims to evaluate the clinical profile in patients with urothelial neoplasms and correlate the expression of HER2/neu and Ki-67 in urothelial carcinomas.

This is a five-year retrospective study from June 2017 to May 2022 with forty cases from the Department of Pathology. A microscopic examination was done to assess the tumor stage and histological grade. Immunohistochemistry was performed with HER2/neu and Ki-67.

65% (26/40) of the cases were diagnosed as infiltrating urothelial carcinoma, 30% (12) of the cases as low-grade non-invasive urothelial carcinoma, one case as a papillary urothelial neoplasm of low malignant potential (PUNLMP), and one case as urothelial papilloma. 95.5% of infiltrating carcinomas and 84.5% of low-grade non-invasive carcinomas were Ki-67-positive. A significant correlation was observed between the expression of Her-2/neu and Ki-67 and the 2016 World Health Organization (WHO) grading system of urothelial carcinoma. Moderate-to-strong HER2/neu overexpression (2+ or 3+) was observed in only 18% of cases.

The expression of ki-67 increased with an increase in the grade of tumor, which shows its prognostic importance. The relation between Ki-67 expression and the histologic grade of the tumor and the presence of lymphovascular invasion was significant. A significant correlation was observed between the grade of the carcinoma and the immunohistochemical expression of HER2/neu, in which 19.3% of high-grade carcinoma cases showed immunohistochemical expression of the HER2/neu marker. Further studies with a larger population group are required to establish the role of HER2/neu as a prognostic marker.