A useful panel in proliferative urothelial lesions: an analysis of cytokeratin 20, p53, CD44 and Ki-67 antigens

Urothelium can show several pseudoneoplastic lesions. Mimic lesions diagnosis is therapeutically and prognostically critical but it is often difficult on the basis of morphology alone in bladder biopsy specimen. We studied in a retrospective way an immunohistochemical panel that helps in this differential diagnosis. The panel includes antibodies against cytokeratin 20 (CK20), CD44, Ki67 (MIB-1) e p53 and we applied it to 31 cases of non-neoplastic urothelium (26 urothelial biopsies with reactive atypia and 5 normal urothelium) and 50 cases of urothelial neoplasia where we analized the distribution of the markers over the urothelium. We obtained two different "standard" results, for neoplastic and non-neoplastic urothelium. We were able to prove that this panel is useful, non expensive tool in the differential diagnosis of urothelial proliferative lesions.