SMARCA4-deficient urothelial carcinoma of the urinary tract:a clinicopathological analysis
Objective To study the clinical pathological features and prognosis of SMARCA4-deficient urothelial carcinoma(UC).Methods Five cases of SMARCA4-deficient UC were reviewed,including 1 case reported in literature.We analyzed the clinical pathological features,and discussed the treatment and prognosis of these patients.Results The mean age was 67-year-old,with the predominance of male.All patients had hematuria.The gross examination confirmed a solitary gray white tumor,with focal hemorrhage,and the boundary was not clear.H&E slides demonstrated that tumor cells were poorly differentiated.Tumor cells were focal positive for GATA3,p63 and CK7,with SMARCA4 deficient.The mean Ki-67 index was 45％.All patients applied radical surgery,and pathological reports showed 5 cases were muscle invasion UC.One case showed lymph node metastasis,and two cases showed lymphovascular metastasis.The survival time of patients after surgery varied for 5 days to 5 months,and one patient alive for 6 months with no metastasis detected,and one was lost to follow-up.Literatures showed limited surgical treatment efficacy,and no potent systemic chemotherapy were reported,but these diseases may show unexpected good responses for immune checkpoint inhibition.Conclusion It is important to diagnose SMARCA4-deficient UC in time.The prognosis is poor,but ICI probably effective.
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