Distinguishing between invasive urothelial
carcinoma from other genitourinary lesions such as prostatic and
renal carcinomas can be difficult, and may require highly sensitive immunohistochemical markers. GATA-
binding protein 3 (GATA3) has been reported in a high percentage of urothelial and
breast carcinomas. Mouse monoclonal
uroplakin II (UPII) and p40
antibodies have recently been developed and demonstrated high specificity in urothelial
carcinoma. This study evaluated the immunohistochemical staining sensitivities of UPII, GATA3, p40, and p63 in the detection of invasive urothelial
carcinoma. UPII, GATA3, and p40 were further tested for specificity in lung, breast, colon, kidney, and
prostate cancers. In all invasive urothelial
carcinoma cases, UPII, GATA3, p40, and p63 exhibited sensitivities of 77.7%, 83.5%, 85.4%, and 80.6%, respectively. The combination of UPII, GATA3, and p40
antibodies stained 94.2% (97/103) of all invasive urothelial
carcinoma cases, including 92.2% (71/77) of grade 2-3 urothelial
carcinomas. In addition, GATA3 and UPII showed negative staining in lung
squamous cell carcinomas and p40 showed negative staining in breast infiltrating
ductal carcinomas. The combination of UPII, GATA3, and p40 showed negative staining in
lung adenocarcinoma,
colon adenocarcinoma, and
renal carcinomas. In conclusion, UPII, GATA3, and p40, when used in combination, are highly sensitive in the differential diagnosis of invasive urothelial
carcinoma.