Role of Cytokeratin 20 as a Predictive and Prognostic Marker in Urothelial Neoplasms

Cureus. 2022 Nov 17;14(11):e31607. doi: 10.7759/cureus.31607. eCollection 2022 Nov.

Abstract

Introduction Several clinical peculiarities mark urothelial carcinomas and their biological behavior. Key in these are its relatively indolent course before manifestation and its high recurrence rate. So far, no biomarker has been identified as a predictor for these factors. The current study aims to evaluate the role of cytokeratin 20 (CK20) in non-invasive urothelial carcinomas (pTa and pT1) of the urinary bladder and its diagnostic and predictive role in tumor staging and recurrence. Materials and methods The study utilizes a retrospective, non-clinical approach via immunohistochemical marking of the paraffin-embedded tumor tissues for the initial diagnosis. Expression patterns were compared with tumor grade and stage, as well as the incidence of recurrence within a five-year follow-up period. Results A strong statistical correlation was established between expression and tumor grade, with high-grade tumors showing weak to moderate expression of CK20 while low-grade tumors showed an intensive expression pattern. No correlation was noted between the expression pattern, patient age and gender, tumor stage, and the likelihood of local recurrence. Conclusion While CK 20 is a reliable diagnostic marker when used together with other markers, its expression pattern in our study correlated only with bladder urothelial carcinoma grade.

Keywords: bladder; cytokeratin 20; non-invasive urothelial carcinoma; progression; recurrence; tumor grade; tumor staging; urothelial carcinoma.