ABSTRACT
Bladder cancer is the second most common urological cancer with an estimated 53,200 diagnosed cases and 12,100 resultant deaths in the year 2000. The incidence of bladder cancer has increased over the past two decades due to improved detection rate of the early stages of the disease i.e. superficial bladder cancer, while the decreasing mortality rate results from a decrease in the incidence of invasive and metastatic form of the disease and improvement in the therapy. Angiogenesis is a prerequisite for normal growth and development and abnormal angiogenesis is a critical feature of many diseases including cancers. The molecules that stimulate angiogenesis are called antigenic factors and are released by tumour cells or leukocytes within the turnour. This submitted work has been performed to fulfill the following objectives: 1- Determination of the angiogenic stimulators, Platelet derived growth factor [PDGF] and nitric oxide [NO] in sera as well as basic fibroblast growth factor [bFGF], hyaluronic acid [HA] and hyauronidase [HAase] in urine of patients with bladder cancer as well as reference healthy persons and patients with benign bladder lesions for comparison. 2- Matching of the assayed measures to be correlated with clinicopathological criteria of patients. The current study included 60 patients divided into two groups: I] Group 1: included 30 patients who were already diagnosed as bladder cancer by cystoscopy and biopsy, and further subdivided into 2 subgroups according to the histopathological picture of their cancer tissues into: A] Squamous cell carcinoma [76.7%] included 22 patients B] Transitional cell carcinoma [23.3%] included 8 patients II] Croup II: included 30 patients with benign bladder lesions subjected to: 1] Thorough clinical examination. 2] Urine analysis 3] complete blood picture. 4] Cystoscopy. 5] Biopsy and histopathological examination of the tissue sample. The study also included 14 reference healthy subjects. The work has concluded that serum levels of PDGF were significantly higher [p<0.0001] in patients with bladder cancer compared with both of benign -bladder diseases and the -healthy subjects. Meanwhile, serum levels of PDGF were also significantly higher in-patients with benign bladder diseases compared to healthy persons. Measured bFGF in the urine of patients with bladder cancer was significantly higher with respect to those with benign lesions as well as the reference healthy cases. [P<0.0001]. Urinary HA of bladder cancer patients was also significant higher than those with benign bladder lesion or health persons [p<0.0001]. Urinary HA ase activity was found to be significantly higher in the patients with bladder cancer compared to those with benign bladder lesions and the health pet [P<0.0001]. The serum concentrations of nitric oxide were significantly higher in-patients bladder cancer compared to those with benign with bladder diseases and the healthy group [P< 0001]. This work obviates that measured angiogenic factors [PDGF and bFGF] have a domain role in development of bladder cancer. Hence, angiogenic inhibitors and as beneficial components as adjuvant therapy with surgery, chemotherapy radiotherapy