Correlation of Human Epidermal Growth Factor Receptor (Her2-neu) Marker with the Grades of Urothelial Carcinoma

Background: Urothelial carcinoma is the common carcinoma of urothelium. Its incidence is high in developed countries but itsoccurrence is increasing in developing countries like Pakistan with mortality rate of 3.8/100,000 in males and 1/100,000 in females.HER2 is a member of the human epidermal growth factor receptor (HER/EGFR/ERBB) family.Amplification or over-expression ofthis oncogene has been shown to play an important role in the development and progression urothelial carcinoma.Objective: To evaluate the relationship between HER2/NEU expression and grades of urothelial carcinoma bladderMaterial and Methods: This was a cross-sectional descriptive study for the period of six months from January to June, 2017conducted at Pathology section Rehman Medical Institute Peshawar. After approval from university Ethical board 63 cases wereselected by purposive sampling.The Tissue samples from diagnosed cases of urothelial carcinoma of urinary bladder were included.Cases of urothelial carcinoma from other sites were excluded. Paraffin embedded tissue blocks were cut and sections stained byH&E to evaluate histopathological features and tumor grades. Immunohistochemical expression of HER2 was determinedapplying standard techniques of immunohistochemistry.Results: Out of total 63 cases, 47 were males and 16 were female with a mean age of 60.7 years (range 14-90 years). There were38 High grade, 23 Low grade and 2 cases of PUNLMP. 36 cases were positive for HER2 expression in which 26(72.2%) were Highgrade, 9(25%) of Low grade and 1(2.7%) of PUNLMP. High grade was more common in HER2 positive cases and this relationshipwas significant (p<.05). Among positive 36 cases, 19 cases of +3 score were High grade, 05 in Low grade and 01 in PUNLMP whilescore 2+ was in 07 cases of High grade and 04 were in Low grade. The relationship of HER2 score was not significantly related tograde of tumor (p>.05)Conclusion: HER2 is highly expressed in high grades of urothelial carcinoma bladder and this relationship between HER2expression and tumor grades is statistically significant.Keywords: HER2, Urothelial carcinoma, Grades, Immunohistochemistry