Receptor Tyrosine Kinase Pathway and Infiltrating Urothelial Carcinoma

J Environ Pathol Toxicol Oncol. 2023;42(1):65-77. doi: 10.1615/JEnvironPatholToxicolOncol.2022044380.

Abstract

Receptor tyrosine kinase pathway is frequently searched for cancer causing mutations in tumors. Emerging targeted therapies are gleam of hope for them. Infiltrating urothelial carcinoma can have many morphological aspects according to their differentiation/variants. To evaluate KRAS, BRAF, and PIK3CA mutations and HER2, EGFR, and p16 expression, we divided urothelial carcinomas into two groups: differentiated/variants (n = 12) and conventional (n = 12). We compared results with clinical, demographic, histopathologic features and survival rates. No statistically significant results could be obtained in the comparison of histopathologic properties/survival rates with mutation analysis and EGFR, HER2, and p16 status. Differentiated/variants urothelial carcinoma showed higher EGFR expression (P < 0.001). Glandular differentiation was the most frequent type, followed by squamous and sarcomatoid differentiation. We observed the most common mutation at KRAS with a propensity for urothelial carcinoma with glandular differentiation. More than one mutation/high protein expression was seen in some tumors. Targeted therapies for KRAS mutation can be effective at urothelial carcinoma with glandular differentiation. Heterologous expression of relevant proteins and genes can be a cause for targeted treatment obstacle. The determination of the molecular characters of tumors is a guide in creating targeted treatment algorithms and in choosing the patient.

MeSH terms

  • Carcinoma, Transitional Cell* / genetics
  • ErbB Receptors / genetics
  • Humans
  • Mutation
  • Proto-Oncogene Proteins p21(ras) / genetics
  • Urinary Bladder Neoplasms* / genetics

Substances

  • Proto-Oncogene Proteins p21(ras)
  • ErbB Receptors