Immunohistochemical Expression of HER2/neu and β-catenin in Urothelial Carcinoma: “A Dawn of Hope"

Background: Urothelial carcinoma is the 10th most commonly occurring and 13th most common cause of cancer-related deaths worldwide. The major prognostic factors in urothelial carcinomas are the depth of invasion into the bladder wall and the degree of differentiation of the tumour. However, there is no reliable prognostic marker, and thus molecular markers are required to estimate the individual prognosis of patients as well as for effective treatment. Methods: To evaluate HER2/Neu and β-catenin immunohistochemical (IHC) expression in urothelial carcinoma and their correlation with tumour grade and stage, thus contributing as prognostic factors. Fifty formalin-fixed TURBT specimens of urinary bladder carcinoma were collected from our hospital during the period from January 2023-June 2024. Hematoxylin and Eosin stained sections were done, along with microscopical examination, and immunohistochemistry for HER2/Neu and 8-catenin were done. A p-value of <0.05 was considered statistically significant. Results: A total of 38 (82%) out of 46 cases of high-grade urothelial carcinoma and 24 (92.3%) out of 26 cases of muscle-invasive urothelial carcinoma expressed strong HER2/Neu membranous positivity (score 3). HER2/Neu expression was found to be statistically significant with respect to histological grade and pathological stage (p< 0.001). 42/46 cases of high-grade urothelial carcinoma showed β-catenin positivity, and intensity increased with an increase in pathological stage (p<0.001). Conclusion: A positive association between HER2/Neu and 3-catenin expression with tumour grade and pathological stage of urothelial carcinoma was found, contributing to prognostic assessment and thereby guiding targeted therapy.