The Effect of C-erbB-2 Expression on Clinical-Pathological Prognostic Factors and Survival Ratios in Urothelial Tumors

INTRODUCTION: Overexpression and the amplification of proto-oncogenic c-erythroblastic oncogene B (c-erbB-2) (HER-2/neu) encode transmembrane growth factor glycoprotein and are a part of the type I receptor tyrosine-protein kinase. It is known to play a role in the treatment of breast and stomach carcinomas. C-erbB-2 overexpression and amplification in urothelial carcinomas have also been demonstrated in many studies. However, possible treatment options and prognostic values are still not sufficiently defined. This study aims to determine the overexpression rate of c-erbB-2 in urothelial carcinomas. In addition, we sought to determine if there was a relationship between c-erbB-2 overexpression and clinical-pathological prognostic factors, such as histological grade, pathological stage, lymph node and distant organ metastasis, and survival time.
METHODS: C-erbB2 overexpression was examined using an immunohistochemical method performed on paraffin block samples of patients diagnosed with primary bladder urothelial carcinoma (n=41). The relationship of the data obtained after this examination with classical clinical-pathological prognostic factors, such as histological grade, pathological stage, regional lymph node metastasis, distant organ metastasis, and survival, was investigated. The obtained data were evaluated statistically. The alpha significance value was 0.05.
RESULTS: C-erbB-2 overexpression was positive in 9.75% (4/41) of the cases. c-erbB-2-positive tumors were all found to be at a high level. One patient was in stage T2, one stage T3, and two in stage T4. Three positive cases had lymph node metastasis; one patient did not have lymph node metastasis. Remote organ metastasis was not observed in any positive cases, and all positive cases were reported to survive. The fact that 75% (3/4) of the positive cases were lymph node metastasis may contribute to the literature.
DISCUSSION AND CONCLUSION: Standardized laboratory methods should be used and studied in large series, including more patients representing various races to evaluate c-erbB-2 overexpression and amplification status in urothelial tumors as a treatment option with prognostic value.