Expression of HER2 and topoisomerase II α in urinary bladder transitional and squamous cell carcinoma

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Carcinoma of the bladder is a worldwide health problem, and ranks ninth in cancer incidence rates. Mortality associated with bladder cancer is the highest in Egyptian males. The incidence of HER2 overexpression in bladder cancer ranges from 2 to 74% of tested cases. It has the highest prevalence among all human malignancies. Despite its prognostic significance, determination of HER2 status in patients with bladder cancer may have therapeutic implications. Topoisomerase II α (TOP2α) is one of the intracellular targets for anthracycline-based therapy. Its overexpression is linked to high-grade tumors, muscle-invasive growth, and poor prognosis.


We aimed to assess the immunohistochemical expressions of HER2 and TOP2α in transitional and squamous cell carcinomas (SCC) of the urinary bladder and study their relationship with clinicopathological parameters.

Materials and methods

The present study included 64 archival cases (52 transitional and 12 SCC) stained using HER2 and TOP2α antibodies.


HER2 was negative in 76.9% of transitional cell carcinoma (TCC) and 100% of SCC cases. TOP2α was positive in 51.9% of TCC and 16.7% of SCC cases. TOP2α showed significant association with low stage in the TCC group (P=0.05). TOP2α was positive in most of the TCC cases compared with SCC cases (P=0.05). No significant concordance in expression was observed between HER2 and TOP2α in TCC cases (P=0.42).


According to our results, more than half of TCC cases were either positive for both HER2 and TOP2α or positive for one of them. Therefore, target therapy against these proteins could have a significant role in the management of Egyptian patients.

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