The expression of Beta Human Chorionic Gonadotrophin (β-HCG) in human urothelial carcinoma

INTRODUCTION: Studies regarding the immuno-histological expression and relevance of Beta-Human Chorionic Gonadotrophin (=-HCG) in urothelial carcinoma are few. There is also no clear cut way of predicting exactly which superficial urothelial carcinomas would subsequently recur or progress and which muscle-invasive urothelial tumours would progress. The objective of the study was to study the immunohistological expression of =-HCG in urothelial carcinoma with regards to grade, category and outcome following treatment METHODS: The expression of =-HCG in urothelial carcinomas of 86 patients was studied with regards to grade, stage and outcome using an immunohistological (ABC) method and formalin fixed/paraffin embedded tumours. RESULTS: Of the 86 tumours (55 superficial and 31 muscle-invasive) studied 45, 16 and 26 were graded as G1, G2, and G3 respectively. Thirteen of the 55 superficial tumours were positively stained for β=-HCG and 42 negatively stained. Twenty of the 31 muscle-invasive tumours studied were positively stained for β=-HCG and 11 were negative. Of the 13 β=-HCG positive superficial tumours only one did not recur at follow up and 12 subsequently recurred, of the 42 β=-HCG negative superficial tumours 19 did not recur and 23 recurred. Only one of twenty patients with β=-HCG positive muscle-invasive tumours survived; 6 of 11 patients with β=-HCG negative muscle-invasive tumours survived. The results indicate that positive staining of the tumours was more commonly associated with tumours of higher grade, higher stage and inferior outcome. CONCLUSION: The Immunohistological expression of β=-HCG would likely predict superficial tumours that would recur and muscle-invasive tumours with inferior outcome.