EXPRESSION OF PROGNOSTIC MARKERS IN CARCINOMA IN SITU OF URINARY BLADDER IN EGYPTIAN PATIENTS

Abstract

The present study aims at evaluation of different categores of cancer causing genes represented by protooncogenes EGF-r, P53, antiapoptotic marker bci-2 gene and the cell surface receptor, tumour suppressor gene E-cadherin and their value in characterization and diagnosis of carcinoma in situ (high grade intraurethelial neoplasia) and dysplasia (low grade intrauretheial neoplasia) of the urinary bladder, as this matter is frequently cause diagnostic problems. The second aim was to correlate their results with other clinicopathologic variables including, histologic type, pathologic grade, schistosomal infection, presence of associated invasive carcinoma and the survival.

Our material of study included 45 cases of bladder CIS (39TC type and 6SC-type). These cases were diagnosed and treated at the Urology and Nephrology Center Mansoura University during the period between January 1998 and December 1999. All the cases were followed up for 30 months till Jully 2001. All the patients underwent cyctoscopy and biopsy. The clinical data were collected from the data base system of the bladder cancer sheet at the archive department in Urology and Nephrology Center, Mansoura Faculty of Medicne.

The results of each marker studied (P53, EGF-r, E-cadherin and bcl-2) were divided the cases of study into three groups by the intensity of staining, and the percent of positive cells for each marker.

Statistical analysis was performed by the Chi square test, the fisher exact probability calculation method. Statistical significance was defined as p<0.05.

The histological findings showed that out of the 45 studied cases, 39 was TC type and 6 were SC-type, 19 cases were of low grade and 26 cases were of high grade. Schisrosomasis was detected in 22 cases.

At the end of the study, 2 cases died, 5 cases progressed, 23 cases were static and 15 cases were cured.