Nuclear matrix protein [NMP 22] as a diagnostic tool in urinary bladder cancer

To evaluate the role of urinary nuclear matrix protein NMP22 in urinary bladder cancer diagnosis. From August 2003 to January 2007, 373 patients, were enrolled in this study in Al Noor Specialist Hospital K.S.A and Urology Department in Benha Faculty of Medicine, patients were complaining of hematuria, LUTS, and bladder mass suspected On U/S examination, after clinical evaluation including complete history, general and local examination especially D.R.E, 50 ml of midstream morning urine samples was taken from all patients and examined for complete urine analysis and for detection of urine level of NMP 22 assay, cystoscopy, and TUR resection was done for all the patients and comparative analysis was done for the results of the cystoscopy, histopathology and NMP22 assay results. The results of the present study revealed that there was decreased overall sensitivity [28.2%] and specificity was [75%] ofNMP 22 in diagnosing transitional cell carcinoma of the bladder in comparison with confirmed cystoscopic positive results [98.8%] but the specificity and sensitivity increases in large invasive tumors to be [56.7%], and specificity [75%]. NMP22 could be considered a diagnostic or screening tool only in high grade transitional cell carcinoma, invasive or large advancing tumor, but NMP22 could not replace cystoscopy as the gold standard for cancer bladder diagnosis

Angiogenic factors in Egyptian bladder cancer patients

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

Evaluation of initial, mid-stream and terminal urinary sample for cytology in follow up of bladder cancer and its comparison with cystoscopy

Study was carried out with a view to know which sample of urine [initial, midstream or terninal] is more useful in detecting the malignant cells. Cytological examination of the voided urine is the only non- invasive method of detection, diagnosis and follow up of tumours of the bladder. A pilot project of 75 patients with biopsy proven carcinomas of the bladder was carried out. Each patient provided fractionated urinary samples [initial, midstream. terminal]. The diagnostic value of each group was assessed and the results' were compared with cystoscopic examination. Twenty four [32%] of patients had both positive cytology and cystoscopy. Twenty-seven [36%] of patients had both negative cytology and cystoscopy. The false neative results were 24% and 0.75% were false positive. The fractionated sampling results showed that 93.33% of the urinary samples including initial, midstream and terminal had yielded cytological results, however, in our experience fractionated urinary sampling does not add to the routinely taken sample of urine for cystology. Study confirms that any sample of urine is satisfactory for diagnostic purpose

Resultados clínicos de la técnica de Burch en el tratamiento de la incontinencia urinaria de esfuerzo: experiencia en 53 casos / Clinical results of the Burch technique as treatment of the urinary stress incontinence: experience in 53 cases

La incontinencia urinaria de esfuerzo constituye un motivo frecuente de consulta en la población femenina adulta de nuestra área. En nuestro Servicio, desde 1990, su corrección se realiza rutinariamente con la técnica de Burch. Se presenta experiencia adquirida y se evalúan los resultados obtenidos en 53 pacientes operadas en el Servicio de Urología del Hospital San Juan de Dios, con la técnica antes mencionada, durante el período comprendido de marzo de 1990 a septiembre de 1992. El diagnóstico de la incontinencia urinaria de esfuerzo se basó en la historia clínica y en el examen físico, lográndose un adecuado criterio de selección. El tiempo de seguimiento fue de 6 meses en promedio con un rango de 1 a 20 meses. Las complicaciones observadas fueron relacionadas a la cirugía general. Se obtuvo éxito terapéutico en el 96,2% y sólo dos casos presentaron recidiva (3,8%)