J Pathol Transl Med.  2015 Sep;49(5):389-395. 10.4132/jptm.2015.08.10.

Parafibromin Staining Characteristics in Urothelial Carcinomas and Relationship with Prognostic Parameters

• Karaarslan S
• Yaman B
• Ozturk H
• Kumbaraci

• KMID: 2381394
• DOI: http://doi.org/10.4132/jptm.2015.08.10

Abstract

BACKGROUND
Parafibromin is a recently defined tumor suppressor gene. The aim of our study was to determine the relationships of parafibromin expression in urothelial carcinomas (UCs) with prognostic parameters and to evaluate the use of parafibromin as a potential marker of UC.
METHODS
Parafibromin expression was assessed in 49 UC specimens using immunohistochemistry. The correlations between parafibromin expression and clinical and pathologic parameters were investigated.
RESULTS
Of the patients, 42 (85.7%) were male, and the mean age was 69.6 +/- 8.2 years (range, 54 to 88 years). Morphologically, the UCs were divided into two groups: papillary (n = 27) and non-papillary (n = 22). There were seven low-grade (14.3%) and 42 high-grade (85.7%) tumors. Parafibromin was negative in 13 tumors (26.5%), partially positive in 19 tumors (38.8%), and positive in 17 tumors (34.7%). Parafibromin expression was more negative in UCs from upper urinary locations (n=17) and with muscularis propria invasion (n=28), which was statistically significant (p = .009 and p = .007, respectively). There was no statistically significant relationship between parafibromin expression and gender, age, tumor grade, survival, or disease-free survival.
CONCLUSIONS
We found that UC cases with parafibromin positivity had less of a tendency to show muscularis propria invasion and were more commonly located in the lower urinary system. These results need to be confirmed with studies based on larger case series.

Keyword

Parafibromin; Urothelial carcinoma; Muscularis propria; Papillary; Non-papillary

MeSH Terms

Disease-Free Survival
Genes, Tumor Suppressor
Humans
Immunohistochemistry
Male

Figure

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  Fig. 1. Parafibromin staining in differant types of urothelial carcinomas. (A) Parafibromin positivity on immunohistochemical evaluation of non-invasive high-grade papillary urothelial carcinoma. (B) Parafibromin positivity in the invasive areas of high-grade urothelial carcinoma of the bladder. (C) Partial parafibromin positivity in non-invasive low-grade papillary urothelial carcinoma. (D) Parafibromin negativity in non-invasive high-grade papillary urothelial carcinoma.

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  Fig. 2. Parafibromin negativity in minimally invasive high-grade papillary urothelial carcinoma of the ureter. (A) Morphological features of urothelial carcinoma. (B) Parafibromin negativity in the same tumor.

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  Fig. 3. Parafibromin negativity in invasive high-grade papillary urothelial carcinoma of the bladder. (A) Morphological features of urothelial carcinoma. (B) Parafibromin negativity in areas of muscularis propria invasion of the same tumor.

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  Fig. 4. Parafibromin positivity in normal urothelial epithelium.

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