Immunohistochemical expression of markers KI67 and HER 2 NEU and its correlation with clinicopathological parameters in urothelial tumors

Introduction: Bladder cancer is the most common malignancy involving the urinary system and the ninth most common malignancy worldwide. As per Indian cancer registry data in men, it is the ninth most common cancer accounting for 3.9% of all cancer. Interpretation of Immunohistochemical expression of Ki67 and Her2/neu in urothelial tumors and correlation with clinical as well as histopathological parameters might have prognostic value as well as therapeutic implications. Aims & Objectives: To correlate the immunohistochemical expression of Ki67 and Her2Neu with clinical parameters and histopathological parameters in urothelial tumors of urinary bladder. Materials & Methods: Total 40 cases of urothelial tumors were included in this study. Biopsy tissue received, processed, stained with Hematoxylin &Eosin (H&E), ERG and p63 immunohistochemical stain, all staining were applied as per standard protocols on formalin fixed paraffin embedded tissue sections of urothelial neoplasm and examined. Results: The Ki67 expression had significant association with tumor histological grade and muscle invasion. The association of Her2neu expression had significant association with tumor histological grade (p=0.001) and muscle invasion (p=0.001). Muscle invasive tumors showed high expression of Ki67 (70.6%) as compared to non-muscle invasive tumors (30%). Her2neu over expression was in accordance with grade, 31.3%, 60% and 93% of low, intermediate and high grade respectively. Conclusions: Ki67 and Her2neu expression correlated with tumor grade and progression. Evaluation of both Ki67 and Her2neu co-expression was more accurate in predicting the clinical outcome and had therapeutic implications.