Background: Accurate recognition of muscularis propria (MP) and muscularis mucosae (MM) in bladder cancer is crucial as carcinoma confined to lamina propria is treated conservatively, whereas one extending into MP needs radical surgery. Distinguishing MP from MM can be problematic on H&E staining, especially in transurethral resection specimens of bladder tumors (TURBT). Desmin stains both MM and MP equally. Smoothelin is a novel smooth muscle specific marker expressed only in terminally differentiated smooth muscle cells and relatively specific for MP.
Aim: This study was done to evaluate the diagnostic value of Smoothelin and Desmin expression in discrimination between MM and MP.
Methods: This study was conducted in Department of Pathology, Pt. B. D. Sharma, PGIMS, Rohtak, on 55 cases of TURBT specimens. Expressions of Immunohistochemical (IHC) markers - SMA, Desmin and Smoothelin were compared in MM and MP.
Results: SMA and Desminstained MP and MM with equal intensity. Smoothelinshowed absent /weak staining in 96.3% cases and moderate positivity in 3.7% in MM and strong /moderate staining in MP (100%).
Conclusion: The distinct IHC pattern of smoothelin staining in MM and MP proves very useful for accurate staging of urothelial carcinoma.
Impact Factor
2022: 6.012
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