Urothelial carcinoma of the bladder (UCB) is a very heterogeneous disease and divided into invasive and non-invasive disease. In non-muscle-invasive bladder cancer (NMIBC), recurrence after transurethral resection or instillation-therapy, and progression to invasive disease are issues of concern. In muscle-invasive bladder cancer (MIBC), systemic recurrence after radical treatment is a pressing problem, as the available therapies in this setting are of limited efficacy. For both entities there are only few clinicopathological prognostic biomarkers to identify subgroups at risk to aid in decision making to whom to offer early radical cystectomy in case of NMIBC or neoadjuvant/adjuvant chemotherapy in case of MIBC to improve outcomes. Despite advances in surgery and intravesical therapy, up to 30% of NMIBC-patients suffer progression to MIBC. After cystectomy around 50% of MIBC patients suffer local or systemic recurrence and subsequently succumb to the disease. Standard features, like pathological staging and grading, are not sufficient to identify patients at risk beyond doubt. Recent advances in molecular diagnostics in combination with standard pathological features could be used to improve risk stratification of patients, guide treatment plans and ultimately improve outcomes. Immunohistochemical (IHC) analysis can detect altered regulatory pathway-products. Until now a plethora of prognostic IHC-biomarkers has been reported on in UCB, but only few have been validated and no biomarker is in routine use or recommended by guidelines. In this review we discuss the prognostic potential of the most promising IHC-biomarkers in NMIBC and MIBC with a focus on prognostication of recurrence and stage progression in NMIBC as well as recurrence-free, cancer-specific and overall survival in MIBC.

膀胱尿道上皮癌（UCB）是一种非常不同的疾病，分为侵入性和非侵入性疾病。在非肌肉浸润性膀胱癌（NMIBC）中，经尿道切除或滴注治疗后的复发以及进展为浸润性疾病是令人关注的问题。在肌肉浸润性膀胱癌（MIBC）中，根治性治疗后的全身复发是一个紧迫的问题，因为在这种情况下可用的疗法疗效有限。对于这两个实体，只有很少的临床病理学预后生物标记物可以识别有风险的亚组，以帮助决策者在NMIBC的情况下向谁提供早期根治性膀胱切除术，在MIBC的情况下可以向新辅助/辅助化疗以改善结局。尽管在外科手术和膀胱内治疗方面取得了进步，但仍有多达30％的NMIBC患者发展为MIBC。膀胱切除术后，约有50％的MIBC患者遭受局部或全身复发，随后死于该疾病。病理分期和分级等标准功能不足以毫无疑问地确定有风险的患者。与标准病理特征相结合的分子诊断技术的最新进展可用于改善患者的风险分层，指导治疗计划并最终改善治疗效果。免疫组织化学（IHC）分析可以检测到调节途径产物的改变。到目前为止，UCB中已报道了多种预后的IHC生物标志物，但只有少数经过验证，并且常规使用或指南未建议使用生物标志物。