Expression of Transforming Growth Factor Beta-1 Protein and Its Receptor in Tissues of Patients with Bladder Cancer Associated with Schistosomiasis or Not Associated

Abstract

Objective: To study the expression of transforming growth factor beta 1 (TGFB1) protein and TGFB R1 (receptor) in bladder tissue sections of patients with bladder cancer (urothelial carcinoma and squamous cell carcinoma) associated with schistosomiasis or not and to correlate both markers with tumor grade, pathological stage and schistosome infestation. Patients and Methods: Sixteen patients with chronic cystitis and 60 with malignant bladder lesions (33 bladder cancer cases associated with schistosomiasis and 27 not associated) were included in the study. Five healthy individuals served as controls. TGFB1 protein and TGFB R1 expression in bladder tissue were measured using immunohistochemical techniques. Results: TGFB1 showed significant over-expression in the malignant group compared to the chronic cystitis group (p < 0.01). TGFB1 was significantly increased in the schistosomal associated bladder cancer (SABC) (including urothelial carcinoma associated with schistosomiasis and squamous cell carcinoma cases) group compared to the non-schistosomal associated bladder cancer group (NSABC) (including urothelial carcinoma not associated with schistosomiasis) (p < 0.05). Expression of TGFB1 was increased with an increase of tumor grade and stage. TGFB R1 showed decreased expression in urothelial carcinoma compared to the squamous cell carcinoma cases (p < 0.05). TGFB R1 showed decreased expression in the SABC group compared to the NSABC group (p < 0.05). TGFB R1 showed decreased expression in relation to the histopathological grade and stage. Conclusion: There is increased expression of TGFB1 protein in SABC compared to NSABC, while there is loss of expression of TGFB R1 in SABC compared to NSABC. TGFB1 and TGFB R1 expression could be used as biological markers for prediction of the clinical outcome of bladder carcinoma. This may help in selecting patients for more intensive surgical or chemotherapeutic approaches.