Abstract

AimsThe purpose of this study was to determine if any relationship exists between expression of COX2 and iNOS markers and urinary schistosomiasis in bladder cancers.MethodologyImmunohistochemical expression of COX2 and iNOS was assessed in formalin fixed paraffin wax processed tissues obtained from 155 patients with bladder cancers (87 SCC and 68 TCC) and 39 patients with benign bladder cystitis.ResultsThe overall immune-expressions of COX2 and iNOS were 71.6% and 57.2% respectively, of the 194 bladder lesions. A significant Positive association between COX2 or iNOS expression with bladder lesions (SCC, TCC and cystitis) was found (p.value = 0.000). COX2 and iNOS were co-expressed among 73(83.9%) of SCC, 15(22.1%) of TCC and 11(28.2%) of the cystitis group. The relationship between COX2 and iNOS immunostaining and Schistosomal ova positivity was statistically determined by P values 0.0565 and 0.1223 for Cox2 and iNOS, respectively.ConclusionThere are high rates of positive expression of COX2 and iNOS among Sudanese patients with Schistosomal-related bladder lesions. There might be strong association between high rates of bladder cancers and urinary Schistosomiasis in the Sudan since, the great majority of lesions were positive for COX2.

Highlights

  • Bladder cancer represents a significant health problem, as it is the one of the most common cancers [1]

  • Most investigators have accepted the association between cigarette smoking and transitional cell carcinoma (TCC), which is most prevalent in developed western and industrialized counties

  • In the Middle East and Africa, the majority of bladder cancers are Squamous Cell Carcinomas (SCCs), the highest incidence has been seen in Schistosoma endemic areas, notably Sudan and Egypt, where SCC ranges from

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Summary

Introduction

Bladder cancer represents a significant health problem, as it is the one of the most common cancers [1]. Most investigators have accepted the association between cigarette smoking and transitional cell carcinoma (TCC), which is most prevalent in developed western and industrialized counties. In these countries over 90% of the bladder cancer cases diagnosed are transitional cell carcinomas. Cycloxgenase-2 (COX-2) is regarded as induced inflammatory mediator involved in the development of tumors [5] It is an inducible enzyme ( called prostaglandin syntheses) responsible for conversion of arachidonic acid to prostaglandins and other inflammatory mediators [6]. Prominent COX-2 expression has been described in bladder cancers including transitional cell and squamous cell carcinomas and this expression correlates with tumor grade and invasion [8,9]

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