Association of Leptin Receptor Expression with Prognostic Pathological Features in Sudanese Urinary Bladder Carcinoma

Abstract

Bladder carcinoma shows marked pathological heterogeneity, and tissue-based markers may help identify tumors with aggressive pathological features. Data on molecular pathology markers in bladder carcinoma are still limited in African cohorts, including Sudan. This study assessed whether leptin receptor (LEPR) immunohistochemical expression was associated with histological grade, pathological pT category, muscle invasion, and lymphovascular invasion in Sudanese bladder carcinoma. LEPR expression was assessed by immunohistochemistry in 153 archived FFPE urinary bladder carcinoma specimens from four Sudanese institutions and was classified using the immunoreactive score. Urothelial carcinoma predominated in this cohort (136/153, 88.9%). High-grade disease was present in 49/136 urothelial carcinomas (36.0%). Pathological pT category was assessable in 149 cases, with 54/149 tumors (36.2%) classified as pT2 or higher. Muscle invasion was present in 54/149 tumors (36.2%), and lymphovascular invasion was present in 56/149 tumors (37.6%). Moderate LEPR immunoreactivity was more frequent in high-grade than low-grade urothelial carcinomas (28.6% vs 10.3%; p = 0.002). LEPR expression also varied by pT category (p = 0.002), muscle invasion (p = 0.001), and lymphovascular invasion (p = 0.001). Moderate expression was most frequent in pT2-or-higher tumors (35.2%) and was higher in muscle-invasive than non-muscle-invasive tumors (35.2% vs 18.9%). In this Sudanese cohort, higher LEPR expression was observed frequently in tumors with adverse pathological features. Further studies should include matched normal urothelium, outcome data, and adjusted analyses to clarify whether LEPR has biological and prognostic significance.