Schistosoma – Associated Bladder Cancer: is There a Change in The Trend of Cell Type?


ABSTRACT:OBJECTIVE:To compare the contribution of squamous cell and transitional cell types to the schistosoma – related and schistosoma – unrelated bladder cancer among Egyptian patients and to evaluate any significant association of carcinoma in situ (CIS) and stage T1 – TCC in schistosomiasis.MATERIALS AND METHODS:A retrospective study in which the histopathologic records of 196 patients who underwent radical or salvage cystectomy for bladder cancer from August 1994 to December 2000 in Urology and Nephrology Center/ Mansoura University – Egypt, had been carried out.RESULTS:The age range of patients was (29 – 75) with a mean of (55.82 ± 8.81) years. Histopathologic examinations of cystectomy specimens showed schistosomiasis in 81(41.32%) patients while in 115 (58.67%) patients; bladder cancer was schistosoma – unrelated. The cell type of cancer in (80) patients with schistosomiasis, was transitional cell carcinoma (TCC) in 40 (50%), squamous cell carcinoma (SCC) in 37 (46.25%), and adenocarcinoma in 3 (3.75%) patients. In schistosoma – unrelated bladder cancer, TCC was reported in 76 (66.08%), SCC in 34 (29.56%), undifferentiated carcinoma in 4 (3.47%) and adenocarcinoma in 1 (0.86%) patients. CIS associated with (stage T1 – TCC) was reported in 2 (15.38 %) out of 13 patients with schitosoma – related bladder cancer, while it was reported in 3 (14.28%) out of 21 patients with schistosoma – unrelated bladder cancer. There was no significant statistical difference between the two groups.CONCLUSION:Schistosoma – related bladder cancer is still a problem in countries endemic with schistsomiasis. Although the major histological cell type in such cancer is SCC, there is a trend of increasing frequency of schistosoma – related TCC.