ABSTRACT
Background: Bladder cancer is a common malignancy in Egypt and other developing countries in which infection with Schistosoma haematobium is prevalent. Bladder cancer caused by bilharziasis has different clinical and biological characters than that observed in the western world. In this study, we used the TRAP technique to estimate telomerase activity in bilharzial bladder cancer specimens and we correlated the findings with other clinical and pathological findings. Patients and methods: Bladder cancer specimens were obtained from 57 patients who underwent radical cystectomy and pathological diagnosis was obtained in all patients. Tissue samples were frozen in liquid nitrogen and stored at -80 degrees C. Telomerase activity by PCR-ELISA technique was measured using TRAP technique. Results: Our patient group included 45 males and 12 females with a median age of 49 years. The majority of our patients (35/57) have squamous histology and they have proven bilharzial history shown in the pathology specimens. Stage P3b was encountered in 29/57 patients whereas thirty-five patients have grade II tumors. The majority of our patients (41/57) were negative for pelvic nodes metastases. Telomerase activity was detected in 27/57 patients (47.4%). The mean level of telomerase was 0.85+/-0.77 in positive patients and 0.029+/-0.025 in negative patients. The expression of telomerase and its mean level in patients above age of 60, in males and in those with squamous pathology, higher grade of tumors or positive node was higher than those without but the difference did not reach statistical significance (P>0.05). Alternatively, expression was significantly higher in those with stages (P1-P3a) compared with P3b-P4a disease stages (66.6% vs. 37.1, P=0.03). Conclusion: Telomerase activity is increased in bilharzial bladder cancer although to a lesser degree than that reported for TCC in the western world, which could be explained, by different biological behavior or different assay methods. Further larger studies with more number of patients are still needed to determine its potential value for early detection and possible use as a therapeutic target.
ABSTRACT
Interest in translational studies on breast cancer is presently devoted to identifying biological predictors of disease prognosis and response to treatment. In this study, we determined the plasma levels of bcl-2 and nitric oxide in 45 patients with metastatic breast cancer using an ELISA technique and correlated them with clinical and biological factors that may affect the outcome of disease. The results were as follows. The mean level of bcl-2 was 278.44 +/- 383.2 U/L compared with 64.42 +/- 14.4 U/L (p = 0.007) for controls. Levels of bcl-2 were higher in patients less than 50 yr old, premenopausals., GIII tumors, positive nodes, ER positive tumors (p = 0.6, 0.5, 0.9, 0.4, and 0.005, respectively). The site of metastatic disease and the number of metastatic sites did not show statistically significant influences over bcl-2 levels. Furthermore, there was a trend, although not significant, toward improvement of survival in patients with higher levels of bcl-2. The mean level of the nitric oxide (NO) was 297.12 +/- 220.54 microM compared with 13.91 +/- 1.1 microM for controls (p = 0.003). The levels were higher in patients over 50 yr, postmenopausal patients, those with visceral deposits, grade III tumors, positive lymph nodes, and those with disease-free survival of less than 6 mo following primary treatment (p = 0.1, 0.2, 0.1, 0.09, 0.4, and 0.08 respectively). Furthermore, there was no correlation between NO levels and survival (r = 0.002). This study demonstrates a potential role for NO and bcl-2 as prognostic factors in patients with metastatic breast cancer. However, larger studies with more patients together with a comparison of serum levels (ELISA) and tissue levels (MOAb) are still required.
