Expressions of androgen receptor and human epidermal growth factor receptor 2 in urinary bladder urothelial carcinoma with incidental prostate cancer and clinicopathological features of the malignancy
Objective:To investigate the clinicopathological features and prognosis of urinary bladder urothelial carcinoma(UBUC)with incidental prostate cancer(IPCa).Methods:We retrospectively analyzed the clinicopathological features of 65 cases of UBUC and 38 cases of UBUC+IPCa after radical cystoprostatectomy(RCP)from January 2017 to February 2020.We compared their expressions of the immunohistochemical markers androgen receptor(AR)and(human epidermal growth factor receptor 2,HER2)between the two groups of patients,and analyzed their clinicopathological characteristics by chi-square test and their survival rates using the Kaplan-Meier method and log-rank test.Results:The detection rate of UBUC+IPCa was 16.5％,and that of clinically signifi-cant IPCa was 39.5％,with preoperative PSA≥4 μg/L in 23.7％of the patients.Compared with the patients with UBUC,most of the UBUC+IPCa cases had no smoking history(73.8％vs 92.1％,P=0.024),and fewer had histological variants(43.1％vs 10.5％,P=0.003).The incidence rate of vascular invasion was significantly higher in the UBUC than in the UBUC+IPCa group(49.2％vs 21.1％,P=0.005),and so was the rate of advanced cases(67.7％vs 31.6％,P＜0.001).In comparison with the patients of the UBUC group,those of the UBUC+IPCa group showed remarkably higher expressions of AR(9.2％vs 31.6％,P=0.004)and HER2(43.1％vs 71.1％,P=0.006).The mean overall survival time was longer in the UBUC+IPCa than in the UBUC group(48.8 mo[95％CI:2.5-42.6 mo]vs 39.9 mo[95％CI:2.8-34.5 mo]),but with no statistically significant difference between the two groups(P=0.608).Conclusion:Standardized sampling of prostate samples after RCP helps to im-prove the detection rate of IPCa.Preoperative level of PSA is not a good predictor of IPCa.Few patients with UBUC+IPCa have a history of cigarette smoking,and the predominant histological type of the malignancy is high-grade invasive urothelial carcinoma,which is not significantly different from UBUC in prognosis.The expressions of HER2 and AR are significantly higher in UBUC+IPCa than in UBUC,suggesting that UBUC+IPCa may benefit from HER2-and AR-targeted therapy.
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