The transcription factor GATA binding protein 3 (GATA3) is commonly used in surgical pathology as a diagnostic marker to distinguish urothelial carcinomas from other cancer entities. However, the clinical relevance of GATA3 expression in urothelial bladder cancer is not completely clarified. In this study, we investigated GATA3 immunostaining on 2,710 urothelial bladder carcinomas on a tissue microarray platform by using two different antibodies to better understand its impact in relation to pathological parameters of disease progression and patient outcome. Nuclear GATA3 immunostaining was regularly seen in normal urothelium and found in 74%/82% of interpretable urothelial neoplasms depending on the antibody used. Within pTa tumors, the rate of GATA3 positive tumors decreased with advancing grade. GATA3 positivity was seen in 98.6%/99.8% of pTaG2 low-grade, 98.6%/100% of pTaG2 high grade, and 94.9%/99.2% of pTaG3 high grade tumors (p=0.0002). As compared to pTa tumors, GATA3 positivity was markedly less common in muscle-invasive urothelial carcinoma (59.9%/71.6%; p<0.0001). Within pT2-4 cancers, high-level GATA3 immunostaining was associated with presence of lymph node metastasis (p=0.0034), and blood vessel (p=0.0290) or lymphatic invasion (p=0.0005) but unrelated to pT stage. GATA3 immunostaining results for both antibodies were not associated with overall survival in 586 patients treated by cystectomy for pT2-4 urothelial carcinoma. The results of our study identify GATA3 expression as a frequent event in non-invasive urothelial carcinomas with favorable tumor features. Loss of GATA3 immunostaining is linked with muscle-invasive disease but is largely unrelated to pathological parameters and patient prognosis.
Human pathology. 2022 Sep 21 [Epub ahead of print]
Henning Plage, Henrik Samtleben, Sebastian Hofbauer, Kira Kornienko, Sarah Weinberger, Paul Giacomo Bruch, Sefer Elezkurtaj, Florian Roßner, Simon Schallenberg, Martina Kluth, Maximilian Lennartz, Niclas C Blessin, Andreas H Marx, Margit Fisch, Michael Rink, Marcin Slojewski, Krystian Kaczmarek, Thorsten Ecke, Steffen Hallmann, Stefan Koch, Nico Adamini, Sarah Minner, Ronald Simon, Guido Sauter, Tobias Klatte, Thorsten Schlomm, David Horst, Henrik Zecha
Department of Urology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany., Department of Pathology, Academic Hospital Fuerth, Fuerth, Germany., Institute of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany., Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Department of Urology and Urological Oncology, Pomeranian Medical University, Szczeci, Poland., Department of Urology, Helios Hospital Bad Saarow, Bad Saarow, Germany., Department of Pathology, Helios Hospital Bad Saarow, Bad Saarow, Germany., Department of Urology, Albertinen Hospital, Hamburg, Germany., Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: .