A clinico-immunohistopathological study of urothelial neoplasms with an expression of HER2/Neu and Ki-67 in malignant lesions presenting to a tertiary centre

Background: HER2/neu is associated with increased tumor grade, and Ki-67 is related to tumor recurrence and stage progression.This study aims to evaluate the clinical profile in patients with urothelial neoplasms and correlate the expression of HER2/neu and Ki-67 in urothelial carcinomas.Methods: This is a five-year retrospective study from June 2017 to May 2022 with forty cases from the Department of Pathology.A microscopic examination was done to assess the tumor stage and histological grade.Immunohistochemistry was performed with HER2/neu and Ki-67.Results: 65% (26/40) of the cases were diagnosed as infiltrating urothelial carcinoma, 30% (12) of the cases as lowgrade non-invasive urothelial carcinoma, one case as a papillary urothelial neoplasm of low malignant potential (PUNLMP), and one case as urothelial papilloma.95.5% of infiltrating carcinomas and 84.5% of low-grade noninvasive carcinomas were Ki-67-positive.A significant correlation was observed between the expression of Her-2/neu and Ki-67 and the 2016 World Health Organization (WHO) grading system of urothelial carcinoma.Moderateto-strong HER2/neu overexpression (2+ or 3+) was observed in only 18% of cases. Conclusion:The expression of ki-67 increased with an increase in the grade of tumor, which shows its prognostic importance.The relation between Ki-67 expression and the histologic grade of the tumor and the presence of lymphovascular invasion was significant.A significant correlation was observed between the grade of the carcinoma and the immunohistochemical expression of HER2/neu, in which 19.3% of high-grade carcinoma cases showed immunohistochemical expression of the HER2/neu marker.Further studies with a larger population group are required to establish the role of HER2/neu as a prognostic marker..