FASCIN 1 IN UROTHELIAL CARCINOMA OF THE URINARY BLADDER: EVALUATION AND ITS CORRELATION WITH PATHOLOGICAL STAGE OF THE TUMOR

Introduction: In urothelial carcinomas, the degree of invasion plays a major role in prognostication and treatment assessment. In certain instances, evaluating invasion on standard histopathological sections may be challenging. Actin-bundling protein fascin is implicated in the migration of tumour cells and is expressed more intensely in invasive tumours. Objectives: To evaluate the expression of fascin-1 in urothelial carcinoma of urinary bladder and correlate it with different grades of tumor and level of invasion and other clinicopathological parameters.  Material and Methods: Observation study was conducted after approval from the institutional ethical committee. Fascin-1 immunoreactivity was studied in 45 confirmed cases of urothelial neoplasms using monoclonal antibody against fascin by immunohistochemistry. The extent, intensity, and combined immunoreactivity score of fascin-1 cytoplasmic immunoreactivity were evaluated semi quantitatively. Results: 29 cases (64.4%) had high grade urothelial carcinoma, 14 cases (31.1%) had low grade urothelial carcinoma, and two cases (4.4%) had papillary urothelial neoplasm of low malignant potential (PUNLMP) based on histological classification. In stage pTa were two cases (4.4%), of stage pT1 were 16 cases (35.6%), and of stage pT2 were 27 cases (60%). Invasion of the muscularis propria was seen in 27 cases (60%) and invasion of the lamina propria in 43 cases (95.6%). High-grade carcinomas had considerably greater intensity, extent, and combined immunoreactivity ratings, all of which were statistically significant. Furthermore, invasive carcinomas with advanced tumour stages showed strong staining. Conclusion: Overexpression of fascin-1 in urothelial carcinomas may serve as a marker of aggressiveness.