Assessment of the Immunohistochemical Expression of Vitamin D Receptor, β-Catenin, and Ki-67 in Urothelial Carcinoma: A Cross-Sectional Study from Egypt

El-Mosely, Marwa M.; Hasan, Abdulkarim; Tharwat, Mohamed; Abdellatief, Ahmed; Elhawary, Reda; Salem, Mahmoud; Fawzy, Mostafa; Sakr, Dina; Semary, Salah-el-din Sayed O.; Sharaf, Sabah Mohamed; Gamil, Heba; Bawahab, Ahmed Abdulwahab; Mirdad, Dahlia Soleman A.; Abdelwahed, Mohammed S.; Abdellah, Mohamed Mahmoud

doi:10.3390/ijtm6020014

Open AccessArticle

Assessment of the Immunohistochemical Expression of Vitamin D Receptor, β-Catenin, and Ki-67 in Urothelial Carcinoma: A Cross-Sectional Study from Egypt

by

Marwa M. El-Mosely

¹,

Abdulkarim Hasan

^2,*

,

Mohamed Tharwat

³,

Ahmed Abdellatief

³,

Reda Elhawary

²,

Mahmoud Salem

²,

Mostafa Fawzy

²,

Dina Sakr

⁴,

Salah-el-din Sayed O. Semary

⁵,

Sabah Mohamed Sharaf

⁶,

Heba Gamil

⁶,

Ahmed Abdulwahab Bawahab

⁷,

Dahlia Soleman A. Mirdad

⁷,

Mohammed S. Abdelwahed

⁷ and

Mohamed Mahmoud Abdellah

^8,9

¹

Pathology Department, Faculty of Medicine, Zagazig University, Zagazig 44511, Egypt

²

Pathology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt

³

Pathology Department, Faculty of Medicine, Al-Azhar University, Assiut 71524, Egypt

⁴

Histopathology Department, University Hospital Southampton NHS Foundation Trust, Hampshire SO16 6YD, UK

⁵

Pathology Department, Faculty of Medicine, Al-Azhar University, Damietta 34711, Egypt

⁶

Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo 11754, Egypt

⁷

Department of Basic Medical Sciences, College of Medicine, University of Jeddah, Jeddah 21589, Saudi Arabia

⁸

Pathology Department, Faculty of Medicine, Fayoum University, Fayoum 63514, Egypt

⁹

Pathology Department, Faculty of Medicine, Galala University, Attaka, Suez 43727, Egypt

^*

Author to whom correspondence should be addressed.

Int. J. Transl. Med. 2026, 6(2), 14; https://doi.org/10.3390/ijtm6020014

Submission received: 21 January 2026 / Revised: 11 March 2026 / Accepted: 15 March 2026 / Published: 30 March 2026

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Abstract

Background: Conventional urothelial carcinoma (UC) requires accurate risk stratification, particularly differentiation between non-muscle-invasive (NMIBC) and muscle-invasive bladder cancer (MIBC) and between low- and high-grade tumors. This study evaluated immunohistochemical (IHC) expression of vitamin D receptor (VDR), β-catenin, and Ki-67 index in Egyptian patients with conventional UC. Methods: A cross-sectional study was conducted on 58 archived conventional UC cases diagnosed in 2023 at Al-Azhar University Hospitals. VDR positivity was defined as ≥10% cytoplasmic and/or nuclear tumor cell staining. Membranous β-catenin was considered preserved when >80% of tumor cell membranes were stained; otherwise, it was reduced. Nuclear β-catenin was considered positive when ≥5% of tumor nuclei were stained. Ki-67 was categorized as high using a ≥30% cutoff. Associations with grade, muscle invasion status, and lymphovascular invasion (LVI) were analyzed. Results: Mean age was 65.3 ± 9.3 years; 86.2% were males; 51.7% were MIBC. Compared with NMIBC, MIBC was significantly associated with high grade, non-papillary architecture, LVI, and high Ki-67. VDR positivity was detected in 82.7% of cases and showed no significant association with grade, muscle invasion, or LVI. Preserved membranous β-catenin was seen in 34.5% and was significantly associated with tumor grade but not with muscle invasion or LVI; nuclear β-catenin was absent. High Ki-67 (60.3%) was significantly associated with high grade and MIBC, with no association with age, sex, or LVI. Conclusions: In Egyptian conventional UC, Ki-67 was a significant marker for aggressive clinicopathologic features, while VDR lacked discriminatory associations and β-catenin findings were mainly grade-related.

Keywords: urothelial carcinoma; Ki-67; VDR; β-catenin; immunohistochemistry

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MDPI and ACS Style

El-Mosely, M.M.; Hasan, A.; Tharwat, M.; Abdellatief, A.; Elhawary, R.; Salem, M.; Fawzy, M.; Sakr, D.; Semary, S.-e.-d.S.O.; Sharaf, S.M.; et al. Assessment of the Immunohistochemical Expression of Vitamin D Receptor, β-Catenin, and Ki-67 in Urothelial Carcinoma: A Cross-Sectional Study from Egypt. Int. J. Transl. Med. 2026, 6, 14. https://doi.org/10.3390/ijtm6020014

AMA Style

El-Mosely MM, Hasan A, Tharwat M, Abdellatief A, Elhawary R, Salem M, Fawzy M, Sakr D, Semary S-e-dSO, Sharaf SM, et al. Assessment of the Immunohistochemical Expression of Vitamin D Receptor, β-Catenin, and Ki-67 in Urothelial Carcinoma: A Cross-Sectional Study from Egypt. International Journal of Translational Medicine. 2026; 6(2):14. https://doi.org/10.3390/ijtm6020014

Chicago/Turabian Style

El-Mosely, Marwa M., Abdulkarim Hasan, Mohamed Tharwat, Ahmed Abdellatief, Reda Elhawary, Mahmoud Salem, Mostafa Fawzy, Dina Sakr, Salah-el-din Sayed O. Semary, Sabah Mohamed Sharaf, and et al. 2026. "Assessment of the Immunohistochemical Expression of Vitamin D Receptor, β-Catenin, and Ki-67 in Urothelial Carcinoma: A Cross-Sectional Study from Egypt" International Journal of Translational Medicine 6, no. 2: 14. https://doi.org/10.3390/ijtm6020014

APA Style

El-Mosely, M. M., Hasan, A., Tharwat, M., Abdellatief, A., Elhawary, R., Salem, M., Fawzy, M., Sakr, D., Semary, S.-e.-d. S. O., Sharaf, S. M., Gamil, H., Bawahab, A. A., Mirdad, D. S. A., Abdelwahed, M. S., & Abdellah, M. M. (2026). Assessment of the Immunohistochemical Expression of Vitamin D Receptor, β-Catenin, and Ki-67 in Urothelial Carcinoma: A Cross-Sectional Study from Egypt. International Journal of Translational Medicine, 6(2), 14. https://doi.org/10.3390/ijtm6020014

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Assessment of the Immunohistochemical Expression of Vitamin D Receptor, β-Catenin, and Ki-67 in Urothelial Carcinoma: A Cross-Sectional Study from Egypt

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