Comparative analysis of changes in proliferative-apoptotic and hormonal status of non-invasive papillary urothelial carcinomas with molecular subtypes of invasive carcinomas
Invasive urothelial carcinoma is the most common bladder malignancy, comprising 90% of all primary bladder carcinomas. According to the statistics of Georgia, according to NCDC data, bladder cancer is the third most common cancer among men. As a result of non-invasive urothelial carcinoma, 70% of the operated patients developed a recurrence in the 5-year period after the surgical intervention on the urinary bladder, among which the share of advanced, metastatic cases is 10-20%.Therefore, regardless of the same degree of differentiation and staging, the recurrence and progression of urothelial carcinoma varies in different patients. A cohort retrograde study was carried out, for which archival material of the teaching-scientific and diagnostic laboratory of Tbilisi State Medical University for the years 2019-2021 was used. The results of the study showed that molecular subtypes of urothelial invasive carcinomas express CK20 and CK5 with different intensity. Moreover, there are mixed, hybrid forms with the coexistence of both markers, which indicates the intratumoral heterogeneous nature of invasive carcinomas, which probably depends on the different clinical course and prognosis of tumors of the same histological type. The phenotypic characteristics of low- and high-grade non-invasive papillary urothelial carcinomas are fundamentally different from the characteristics of invasive urothelial carcinoma, which gives reason to assume that they are different tumors and require additional genomic changes to transform into invasive carcinoma.The phenotypic differences between them are likely to determine the risk of recurrence and invasive transformation. CK20, CK5, apoptotic and proliferative characteristics with androgen receptor expression. Together, it can be used to assess the risk of recurrence and transformation to invasive carcinoma of low- and high-grade noninvasive papillary urothelial carcinomas.