1. Comparison of tissue biomarkers between non-schistosoma and schistosoma-associated urothelial carcinoma.
- Author
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AlHariry, Nashwah Samir, El Saftawy, Enas A., Aboulhoda, Basma Emad, Abozamel, Ahmed H., Alghamdi, Mansour A., Hamoud, Amany E., and Khalil Ghanam, Walaa Abd Elgawad
- Subjects
TRANSITIONAL cell carcinoma ,ESTROGEN receptors ,EPIDERMAL growth factor receptors ,TUMOR necrosis factors ,BIOMARKERS ,BREAST - Abstract
High-grade urothelial carcinoma either non- Schistosoma (NS-UBC) or Schistosoma (S-UBC)-associated is the tenth cause of death worldwide and represents a serious therapeutic problem. Evaluation of the immmunohistochemical expression of tumor necrosis factor-alpha (TNFα), epidermal growth factor receptor (EGFR), programmed cell death protein-1 (PDL1), estrogen receptor-alpha (ERα) and UroplakinIII, in the high-grade in NS-UBC and S-UBC as potential prognostic and therapeutic targets analyzed through estimation of area percentage, optical density and international pathological scoring system for each marker. Sixty high grade urothelial carcinoma cases were enrolled in the study (30 cases of NS-UBC and 30 cases of S-UBC). The cases were immunohistochemically-assessed for TNFα, EGFR, PDL1, ERα and Uroplakin III expression. In S-UBC, parasite load was also evaluated for correlation with the immunohistochemical markers' expression in S-UBC. The area percentage of immune-expression of TNFα and EGFR was higher in S-UBC compared to NS-UBC. On the other hand, the NS-UBC displayed statistically-higher expression of PDL1 and uroplakinIII (p-value <0.001). ERα revealed higher, yet, non-significant expressions in S-UBC compared to NS-UBC (p-value =0.459). PDL1 expression showed the most superior record regarding area percentage (64.6± 34.5). Regarding optical density, TNF-α showed the highest transmittance expression (2.4 ± 0.9). EGFR positively correlated with PDL1 in S-UBC (r= 0.578, p-value =0.001) whereas in NS-UBC, TNFα and PDL1 (r=0.382, p-value=0.037) had positive correlation. Schistosoma eggs in tissues oppose uroplakin III expression and trigger immunomodulation via PDL1. Due to lower UroplakinIII expression, S-UBC is supposed to have a poorer prognosis. Hormonal therapy is not hypothesized due to a very minimal ERα expression in both NS-UBC and S-UBC. Regarding immunotherapy, anti-TNF-α is suggested for S-UBC whilst in NS-UBC, blockading PDL1 might be useful. Targeted EGFR therapy seems to carry emphasized outcomes in S-UBC. Correlations encourage combined immune therapy in NS-UBC; nevertheless, in S-UBC, combined anti-EGFR and PDL1 seem to be of benefit. • Uroplakin III showed minimal expression in S-UBC indicating poor prognosis. • The weak expression of ER does not support hormonal therapy in both S-UBC and NS-UBC. • Anti-TNF is recommended in S-UBC. • Blockage of the PD-1/PDL1 pathway is suggested be efficient in NS-UBC. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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