Stains & CD markers
Uroplakin II


Last author update: 22 September 2022
Last staff update: 22 September 2022

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PubMed Search: Uroplakin II

Harsh Batra, M.B.B.S., D.C.P., D.N.B.
Anil Parwani, M.D., Ph.D., M.B.A.
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Cite this page: Batra H, Parwani A. Uroplakin II. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stainsUroplakinii.html. Accessed December 3rd, 2022.
Definition / general
  • Uroplakin II, a 15kDa protein that is part of the uroplakin family (UP1a, UP1b, UPII and UPIII), which forms the urothelial plaque covering the apical surface of the urothelium
Essential features
  • Uroplakins are terminal differentiation products that are exclusively expressed in urothelial cells (Kidney Int 2009;75:1153)
  • 15 kDa transmembrane protein involved in terminal differentiation of urothelium
  • Exists as a heterodimer along with UP1a (Kidney Int 2009;75:1153)
  • UPII IHC has significantly higher sensitivity (57% versus 50%) than UPIII and the same specificity (~99%) for urothelial carcinomas (Histopathology 2014;65:132)
  • Helpful in pinpointing the origin where secondary involvement by prostate adenocarcinoma or metastatic carcinoma may be positive for GATA3
Terminology
  • UPII, UPK2, UROII
Clinical features
  • Highly specific and moderately sensitive for urothelial carcinomas
  • Helpful in pinpointing the primary origin as urothelium in cases where GATA3 is inconclusive
Interpretation
Uses by pathologists
  • Highly specific and moderately sensitive for urothelial carcinomas
  • Helpful in ascertaining the primary origin as urothelium, especially in cases where GATA3 is inconclusive
  • Currently recommended by ISUP as a second line additional marker to confirm urothelial primary (Am J Surg Pathol 2014;38:e20)
Prognostic factors
Microscopic (histologic) images

Contributed by Charles C. Guo, M.D., Varsha Nair, M.D., Prih Rohra, M.D., Priya Rao, M.D. and Bogdan A. Czerniak, M.D., Ph.D.
Bladder, invasive urothelial carcinoma

Bladder, invasive urothelial carcinoma

Bladder, papillary urothelial carcinoma

Bladder, papillary urothelial carcinoma

Positive staining - normal
  • Apical expression in normal bladder epithelium (umbrella cells)
  • Intermediate cells in normal bladder epithelium
Positive staining - disease
Negative staining
Molecular / cytogenetics description
  • UPII mRNA expression in tissue and peripheral blood is associated with lymph node metastasis (J Pathol 2003;199:41)
Sample pathology report
  • Lymph node, pelvic node dissection:
    • Metastatic urothelial carcinoma (see comment)
    • Comment: Histologic sections show a lymph node with deposits of tumor cells in diffuse sheets and few with a trabecular pattern. The cells are round to polygonal, demonstrating moderate pleomorphism, inconspicuous nucleoli and high N:C ratios. Immunohistochemistry is positive for CK20, p63, GATA3, S100, uroplakin III and uroplakin II and negative for PSA, PSAP, NKX3.1 and prostein, suggesting a urothelial origin. Please correlate clinicoradiologically. Follow up is advised.
Board review style question #1
Uroplakin II forms a heterodimer with which other uroplakin?

  1. UPIa
  2. UPIb
  3. UPIII
  4. UPV
Board review style answer #1
A. UPIa

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Reference: Uroplakin II
Board review style question #2
Uroplakin II is expressed normally in which of the following?

  1. Apical region (umbrella cells) of urothelium
  2. Muscularis propria of bladder
  3. Normal breast tissue
  4. Prostate
Board review style answer #2
A. Apical region (umbrella cells) of urothelium

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Reference: Uroplakin II
Board review style question #3

Uroplakin II is highly specific for which of the following?

  1. Infiltrating ductal carcinoma, NOS, breast
  2. Lung adenocarcinoma
  3. Prostate carcinoma
  4. Urothelial carcinoma
Board review style answer #3
D. Urothelial carcinoma

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Reference: Uroplakin II
Board review style question #4
Which of the following is true regarding uroplakin II, as compared to uroplakin III?

  1. Equally sensitive IHC marker for urothelial carcinoma
  2. Less sensitive IHC marker for urothelial carcinoma
  3. Less specific IHC marker for urothelial carcinoma
  4. More sensitive IHC marker for urothelial carcinoma
Board review style answer #4
D. More sensitive IHC marker for urothelial carcinoma

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Reference: Uroplakin II
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