Abstract
BackgroundPlasmacytoid urothelial carcinoma (PUC) of the urinary bladder is a variant of urothelial carcinoma that carries a poor prognosis. The epithelial-mesenchymal transition (EMT) has been demonstrated to contribute to tumor progression. As the cause of the increased aggressiveness of PUC is unknown, we investigated PUC and EMT-related marker expression.MethodsA total of 633 bladder carcinoma cases diagnosed from 2006 to 2015 at the Nippon Medical School Hospital were analyzed. Twelve patients were found to have plasmacytoid histology and diagnosed with PUC. Slides were evaluated for percentage of plasmacytoid variant, and stained for E-cadherin, N-cadherin, Vimentin, Fibronectin and Snail expression.ResultsThe incidence of PUC was 1.9% (12/633). The median patient age at diagnosis was 71 years (range, 60–80 years) and the male-female ratio was 11:1. All but three patients had stage T2b or higher. The median overall survival was 10 months. In 10/12 cases, Snail and N-cadherin were positive. Vimentin was positive in 9/12 cases. Fibronectin was positive in 8/12 cases. While E-cadherin was negative in 10/12 cases. Nine cases showed > 10% plasmacytoid component. Eight of the nine patients (88.9%) with > 10% plasmacytoid component died.ConclusionsThe results indicate that PUC may induce EMT and may be associated with high invasion.
Highlights
Plasmacytoid urothelial carcinoma (PUC) of the urinary bladder is a variant of urothelial carcinoma that carries a poor prognosis
The present study examined the expression status of epithelial-mesenchymal transition (EMT)-related markers (E-cadherin, N-cadherin, Vimentin, Fibronectin and Snail) in PUC
The amount of PUC as a percentage was evaluated in the transurethral resection of bladder tumor (TURBT) and compared with that in the cystectomy when available
Summary
Plasmacytoid urothelial carcinoma (PUC) of the urinary bladder is a variant of urothelial carcinoma that carries a poor prognosis. The epithelial-mesenchymal transition (EMT) has been demonstrated to contribute to tumor progression. As the cause of the increased aggressiveness of PUC is unknown, we investigated PUC and EMT-related marker expression. Plasmacytoid urothelial carcinoma (PUC) of the urinary bladder was first reported in 1991 as a similar histological type to plasma cell [1]. The World Health Organization (WHO) working group classified PUC as a variant of urothelial carcinoma (UC). These tumor cells have eosinophilic cytoplasm and eccentrically placed, enlarged hyperchromatic nuclei with small nucleoli [2]. Later inquire about proposes that the epithelialmesenchymal transition (EMT) is a vital figure related to tumor progression and metastasis [4, 5]. Snail is a superfamily of zincfinger transcription factors that was, to begin with
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