Department of Urology, Theodor Bilharz Research Institute, Kornish El Nil, 12343, Embaba/Giza, P.O.B. 30, Cairo, Egypt.
Department of Pathology, Theodor Bilharz Research Institute, Cairo, Egypt.
Infect Agent Cancer. 2014 Jun 26;9:21. doi: 10.1186/1750-9378-9-21. eCollection 2014.
Infection with urinary schistosomiasis and its severity are oncogenic factors for developing carcinoma of the bladder, whether it is urothelial carcinoma (UC) of a transitional cell type (TCC) or non-urothelial of squamous cell carcinoma (SCC). In UC it is not defined whether it is schistosomal or not. This led to controversial results in expression of tumour markers, tumour prognosis, and response to therapy.
We assessed the application by immunohistochemistry method (IHC) for detection of schistosomal antigen in bladder cancer tissue samples to differentiate UC associated with or without schistosomiasis. Urothelial carcinoma stage, grade, and progression were correlated with the density, intensity, and index of schistosomal antigen expression. Follow up was done for 2-5 years.
Archival tissue samples of 575 patients were studied: 515 urothelial carcinoma, 30 patients with SCC associated with schistosomiasis, and a control group of 30 patients without schistosomiasis.
Expression of schistosomal antigen in tissue was done by IHC using monoclonal antibodies (MAbs) against schistosomal antigens (SA). Correlation of intensity of antigen expression to clinical and pathological data was analysed.
We identified 3 parameters of antigen expression: density, intensity and index with 4 grades for each. SCC-group was 100% positive. UC was positive in 61.4% distributed as follows: Ta: 37.5%, T1: 62%, and muscle invasive T2-4 were 64%. Upstaging, metastases and recurrence were correlated with high index in T1 and T2-4 tumours.
Urothelial carcinoma associated with schistosomiasis was defined by the positive expression of schistosomal antigens in tissues detected by lHC using MAbs against schistosomal haematobium. Upstaging and progression of T1 and T2-4 were correlated with high density, intensity, and index of antigen expression. Non-schistosomal UC had negative expression for schistosomal antigen, which was detected in 36.5% of cases. These results would be of significance in differentiating schistosomal from non-schistosomal bladder cancer of UC and would predict the prognosis in T1, T2-3 tumours. Implementation of IHC using MAbs against SA in UC would help in planning the proper therapy. Schistosomiasis should be considered as an oncogene for UC in endemic areas.
感染尿路血吸虫病及其严重程度是膀胱癌发生的致癌因素，无论是尿路上皮癌（UC）的移行细胞类型（TCC）还是非尿路上皮的鳞状细胞癌（SCC）。在 UC 中，是否为血吸虫病并不明确。这导致在肿瘤标志物的表达、肿瘤预后和治疗反应方面存在争议结果。
我们评估了免疫组织化学方法（IHC）在膀胱癌组织样本中检测血吸虫抗原的应用，以区分是否与血吸虫病相关的 UC。尿路上皮癌的分期、分级和进展与血吸虫抗原表达的密度、强度和指数相关。进行了 2-5 年的随访。
研究了 575 例患者的存档组织样本：515 例尿路上皮癌、30 例与血吸虫病相关的 SCC 患者和 30 例无血吸虫病的对照组。
使用针对血吸虫抗原（SA）的单克隆抗体（MAbs）通过 IHC 检测组织中的血吸虫抗原表达。分析抗原表达强度与临床和病理数据的相关性。
我们确定了抗原表达的 3 个参数：密度、强度和指数，每个参数有 4 个等级。SCC 组为 100%阳性。UC 的阳性率为 61.4%，分布如下：Ta：37.5%，T1：62%，肌肉浸润性 T2-4 为 64%。T1 和 T2-4 肿瘤的升级、转移和复发与高指数相关。
通过使用针对曼氏血吸虫的 MAbs 通过 IHC 检测组织中血吸虫抗原的阳性表达，定义了与血吸虫病相关的尿路上皮癌。T1 和 T2-4 肿瘤的升级和进展与抗原表达的高密度、强度和指数相关。非血吸虫性 UC 对血吸虫抗原的表达为阴性，在 36.5%的病例中检测到。这些结果对于区分 UC 的血吸虫性和非血吸虫性膀胱癌以及预测 T1、T2-3 肿瘤的预后具有重要意义。在 UC 中实施针对 SA 的 MAbs 的 IHC 将有助于制定适当的治疗计划。在流行地区，应将血吸虫病视为 UC 的致癌因素。
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