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The nonbilharzial urothelial carcinoma in Egypt

analysis of risk factors of stage progression in 530 patients

El-Bolkainy, Nabila; El-Bolkainy, Tareka; Mandour, Esamc; Badawy, Omniaa; Abdelbaky, Hebaa; El-Attar, Inasb

Egyptian Journal of Pathology: July 2018 - Volume 38 - Issue 1 - p 22–26
doi: 10.1097/01.XEJ.0000534713.68027.91

Background The control of schistosomiasis in Egypt resulted in a striking change of the histologic profile of bladder cancer with decline of squamous cell carcinoma and rise of urothelial (transitional) carcinoma.

Aim Is to define the demographic and pathologic characteristics of the nonbilharzial urothelial carcinoma in a large series of Egyptian patients (530 transurethral resection samples), as well as to evaluate the risk factors (demographic, pathologic, and tissue biomarkers) in relation to stage progression (pT2).

Results Displayed some differences from comparable western reports. The mean age was 62 years, males predominated (male female ratio 6 : 6), the nonpapillary pattern was common (51%), high-grade carcinomas contributed 40%, and invasion of muscularis propria (pT2) was common (56.2%). Only tumor pattern and grade had a significant relation with stage progression (pT2). In 62 cases, the four tumor tissue markers studied (p53, KI-67, E-cadherin, and metalloproteinase-2) did not show a significant relation with stage progression.

Conclusion Pathologic parameters are more important than biomarkers in determining stage progression. More research efforts are needed in early detection, validation of biomarkers by prospective clinical trials, and development of new models using multiple risk factors to increase their predictive power.

aDepartment of Pathology

bDepartment of Biostatics and Cancer Epidemiology, National Cancer Institute

cDepartment of Pathology Al-Azhar University, Cairo, Egypt

Correspondence to Omnia Badawy, MD, PhD, Department of Pathology, National Cancer Institute, Cairo 11728, Egypt Tel: +20 100 485 6360; e-mail:

Received October 26, 2017

Accepted December 11, 2018

©2018Egyptian Journal of Pathology
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