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Objective: Squamous cell carcinoma (SCC) of the urinary bladder is associated with aggressive behavior and is typically treated with radical cystectomy. Vitamin D receptor (VDR) and its ligand Calcitriol have shown anti-tumor effects in various malignancies but to our knowledge there is no current information on VDR expression in bladder SCC. This study aimed to assess VDR immunostaining patterns in pure bladder SCC and its relation to the available clinicopathological parameters of such tumors. Material and Methods: VDR immunostaining was performed on 35 radical cystectomy specimens from patients with primary pure SCC. Nuclear and cytoplasmic VDR staining was scored separately using the semi-quantitative immunoreactive score. Results: Nuclear and cytoplasmic/membranous VDR expression was present in 35 (100%) and 19 (54.3%) cases, respectively, with a significant negative linear relationship (r=-0.33; p=0.035). Differences in cytoplasmic/membranous VDR expression were found in relation to tumor histology (p=0.018), tumor necrosis (p=0.022), and stage groups (p=0.001). Low cytoplasmic VDR correlated with increased tumor staging (Cc = -0.422), positive lymph node status (Cc = -0.375), and higher stage groups (Cc= -0.438). The median nuclear VDR expression score was significantly higher in advanced stage groups (p= 0.038). Conclusion: Our data suggest that VDR may be a potential prognostic factor in bladder SCC. Further studies and clinical trials using vitamin D supplements may provide a new therapeutic option for those high-risk patients. [ABSTRACT FROM AUTHOR]

Background Pleural effusion may be malignant or nonmalignant, Cytology has been used in malignant pleural effusion (MPE) diagnosis due to its high specificity. Its sensitivity is about 0.6. Cancer ratio (CR) and carcinoembryonic antigen (CEA) may be used in MPE diagnosis. Aim Evaluate the role of CR and CEA as diagnostic markers of MPE and their role in differentiating different types of MPE. Patients and methods This cross-sectional study included 70 patients with pleural effusion admitted to Chest Department, Kasr Alainy Faculty of Medicine, Cairo University. Thirtyfive patients had benign pleural effusions and 35 patients had MPE. Pleural fluid sample obtained from each patient for ADA, CEA, and serum LDH. CR and pleural fluid CEA were compared between patients with MPE and those with benign effusion. Results CR was statistically significantly higher in the malignant group (mean 23.66±7.75) compared with benign group (mean 14.47±11.42) with P value less than 0.001. CR cut-off value was 19.79, the sensitivity and specificity were 74.3 and 82.9%, respectively. Pleural fluid CEA had higher levels in malignant group (mean 104.78±262.7) compared with benign group (mean 2.08±2.49) with P value less than 0.001. The cut-off value of CEA was 3.4 U/l with sensitivity 74.3% and specificity 94.3%. Pleural fluid CEA was significantly higher in metastatic adenocarcinoma (mean 154.58±314.53) compared with other types of malignancy (mean 9.34±17.98) with P value less than 0.001. Conclusion CR and CEA could be used together as simple screening tests in cytology negative MPE with high specificity and sensitivity. CEA was significantly higher in metastatic adenocarcinoma compared with other types of malignancy and could be used to differentiate different types of MPE. [ABSTRACT FROM AUTHOR]