Bilharziasis and bladder cancer: a time trend analysis of 9843 patients

To explore any changes in bladder carcinoma during 37 years period, in regard to: its frequency, bilharzia association, histological profile and demographic data. This is a retrospective study on 9843 patients treated at the National Cancer Institute [NCI], Cairo University, during the years 1970-2007. Three groups were selected: series [A] included 3212 patients during 1970-1974, series [B] 3988 patients during 1985-1989 and series [C] 2643 patients during 2003-2007. For statistical analysis, data of series [A], [B] and [C] were compared to determine the significance of difference [p value 0.005]. A significant decline of the relative frequency of bladder cancer was observed from 27.63% in the old series to 11.7% in the recent series. Bilharzia association dropped from 82.4% to 55.3%. There was a significant rise of transitional cell carcinomas from 16.0% to 65.8%, becoming at present the most common tumor type, with a significant decrease in squamous cell carcinomas from 75.9% to 28.4%. There was an increase in the median age of patients from 47.4 years to 60.5 years and a decrease of male: female [M/F] ratio from 5.4 to 3.3. The decline in the relative frequency of bladder cancer is associated with a decline in bilharzia egg positivity in the specimen and is probably related to better control of bilharziasis in the rural population in Egypt. This was accompanied by a change in the histological profile of tumors, with significant predominance of transitional cell carcinoma and an increase in the age of patients, a pattern rather similar to that in western reports

Immunophenotyping, MIB-1, p53 and mast cell tryptase in large cell non-Hodgkin's lymphoma

The aim of the present study was to explore by immunohistochemical methods, on lymph node and infiltrated bone marrow bioposies. the potential value of MIB-l proliferation rate. p53 overexpression and Mast cell tryptase [MCT] as possible prognostic fators for large cell lymphomas on 69 adult patients for whom paraffin blocks, clinical data and survival information were available. In the reviewed series, large cell lymphoma included: 84.1% large B-cell lymphoma. 11.6% peripheral T-cell lymphoma and 4.3% anaplastic large cell lymphoma. MIB-1 labeling was quantitated by image analysis and cases were classified as either of low or high proliferation rate taking MIB-l count of 50% as a cutoff value. For p53, nuclear immunoreactivity equal to or more than 20% were considered overexpression or positive. As for MCT, presence of> 5 mast cells/hpf was recorded as high count while counts <5 mast cells/hpf were considered low counts. In the L.N. biopsies examined the mean MIB-l labeling rate was 48.5%. p53 positive tumors contributed 33.3% of cases while high MCT counts were detected in 43.5% of cases. High MIB-l rate, p53 positivity and MCT counts showed a statistically significant relation to high lPl and were associated ".ith poor response to therapy and unfavorable 2-year overall survival and hence were considered risk factors. Additionally, high MCT count was found to show a strong relation with T-cell phenotype and extranodal forms. Bone marrow biopsies were examined to detect infiltrated cases. B.M. infiltration was detected in 15 cases whose levels of MIB-l and p53were in accordance to the corresponding L.N. values.MCT counts in B.M. biopsies were within the high count group but were lower than corresponding L.N. values and were strongly related to T-cell phenotype. It is concluded that MIB- 1. p53 and MCT are valuable prognostic factors which could serve as a guideline for treatment by identifying unfavorable cases for more intensive therapy