The Significance of Prolyl 4-Hydroxilase Beta Polypeptide Expression in Urothelial Carcinoma

Abomashhour, Tasneem Abdallah; Assaf, Magda Ibrahim; Abd Elwahab, Mai Mohammed; Abdullatif, Asmaa

doi:10.21608/zumj.2025.412782.4099

The Significance of Prolyl 4-Hydroxilase Beta Polypeptide Expression in Urothelial Carcinoma

Document Type : Original Article

Authors

¹ Demonstrator of Pathology, Faculty of Medicine, Zagazig University, Faculty of Medicine, Zagazig University

² Professor of Pathology, Faculty of Medicine, Zagazig University

³ Assistant Professor of Pathology, Faculty of Medicine, Zagazig University

10.21608/zumj.2025.412782.4099

Abstract

Background: Prolyl-4-hydroxylase subunit beta (P4HB) is an endoplasmic reticulum chaperone implicated in tumor progression, but its clinicopathological significance in urothelial carcinoma remains unclear. This research aimed to evaluate the expression of P4HB in urothelial carcinoma of the urinary bladder and examine its association with key clinicopathological features.

Methods: A retrospective study included 94 cases of urothelial carcinoma. Formalin-fixed, paraffin-embedded tumor samples were examined histologically and immunohistochemically for P4HB expression. Associations between P4HB expression and age, sex, tumor size, grade, stage, muscle invasion, and concomitant carcinoma in situ (CIS) were statistically analyzed.

Results: High P4HB expression was found in 60.3% of tumors >3 cm, compared to 15.4% of those ≤3 cm (p<0.001). Among high-grade tumors, 93.3% showed high P4HB expression, while only 22.4% of low-grade tumors were P4HB-high (p<0.001). Muscle-invasive tumors demonstrated high P4HB expression in 77.4% of cases, in contrast to 9.8% in non–muscle-invasive tumors (p<0.001). No significant relationship was observed between P4HB expression and age (p=0.504) or sex (p=0.628). Concomitant CIS was present in 58.3% of cases with high P4HB expression, but this difference did not reach statistical significance (p=0.235).

Conclusions: Increased P4HB expression is significantly linked with larger tumor size, higher grade, advanced stage, and muscle invasion in urothelial carcinoma. P4HB immunostaining may be helpful as a marker for aggressive disease and could support early detection and prognostic assessment in bladder cancer.

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