ABSTRACT
Recent epidemiological studies have implicated Cytomegalovirus [CMV] infection in the etiology of cancer bladder. The present study was designed to estimate the performance characteristics of different assays, used for identification of CMV infection in schistosomal patients. The study was conducted on sixty cancer bladder patients; thirty five with schistosomiasis [group I] and twenty five without [group II], and twenty control subjects were included [group III]. PCR technique for detection of CMV DNA was performed on bladder tissue, serum, buffy coat and urine. ELISA for detection of IgG and IgM in sera and Antigenemia test and electron miscroscopic studies [EMS] on buffy coat were performed. CMV DNA was significantly detected in group I versus group II by PCR on bladder tissue, buffy coat, and serum respectively. None of the urine samples were positive for CMV DNA. The results of different assays were evaluated in relation to PCR results on tissue biopsies. Antigenemia test showed significant difference between group I versus group II. The EMS was found to increase the sensitivity of PCR on bladder tissue. Both PCR on serum and antigenemia test showed similar sensitivity of 56%, but a specificity of 100% and 81% respectively. In conclusion, the significant association of CMV infection with cancer bladder in Egyptian patients, suggest that the virus may be implicated in the development of such malignant transformation especially in cases with schistosomal affection. Both pp65 antigenemia assay and PCR on serum are two major assays available for diagnosis and monitoring of CMV infections. The EMS could increase the sensitivity and accuracy of PCR on bladder tissue and on buffy coat. Further investigation on a larger number of patients are required in immunodeficient schistosomal cancer bladder patients in order to clarify the role played by CMV in bladder cancer