BackgroundClinical characterization of bladder carcinomas is still inadequate using the standard clinico-pathological prognostic markers. We assessed the correlation between nm23-H1, Rb, EGFR and p53 in relation to the clinical outcome of patients with muscle invasive bilharzial bladder cancer (MI-BBC).Methodsnm23-H1, Rb, EGFR and p53 expression was assessed in 59 MI-BBC patients using immunohistochemistry and reverse transcription (RT-PCR) and was correlated to the standard clinico-pathological prognostic factors, patient's outcome and the overall survival (OS) rate.ResultsOverexpression of EGFR and p53 proteins was detected in 66.1% and 35.6%; respectively. Loss of nm23-H1and Rb proteins was detected in 42.4% and 57.6%; respectively. Increased EGFR and loss of nm23-H1 RNA were detected in 61.5% and 36.5%; respectively. There was a statistically significant correlation between p53 and EGFR overexpression (p < 0.0001), nm23 loss (protein and RNA), lymph node status (p < 0.0001); between the incidence of local recurrence and EGFR RNA overexpression (p= 0.003) as well as between the incidence of metastasis and altered Rb expression (p = 0.026), p53 overexpression (p < 0.0001) and mutation (p = 0.04). Advanced disease stage correlated significantly with increased EGFR (protein and RNA) (p = 0.003 & 0.01), reduced nm23-H1 RNA (p = 0.02), altered Rb (p = 0.023), and p53 overexpression (p = 0.004). OS rates correlated significantly, in univariate analysis, with p53 overexpression (p = 0.011), increased EGFR (protein and RNA, p = 0.034&0.031), nm23-H1 RNA loss (p = 0.021) and aberrations of ≥ 2 genes. However, multivariate analysis showed that only high EGFR overexpression, metastatic recurrence, high tumor grade and the combination of ≥ 2 affected markers were independent prognostic factors.Conclusionnm23-H1, EGFR and p53 could be used as prognostic biomarkers in MI-BBC patients. In addition to the standard pathological prognostic factors, a combination of these markers (≥ 2) has synergistic effects in stratifying patients into variable risk groups. The higher is the number of altered biomarkers, the higher will be the risk of disease progression and death.

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HPV may thus be implicated in the etiology of bilharzial bladder cancer, but a definite causal relationship remains to be demonstrated. HPV together with p53 alterations work in synergy to accelerate the carcinogenic process, as there was concordance in the results of both parameters in 24/41 (58.5%) cases.

Blastocystis is an opportunistic parasite causes gastro-intestinal symptoms including irritable bowel syndrome (IBS). This study evaluated the effect of probiotics and silver nanoparticles on Blastocystis hominis in mice and compared between both probiotics (Lactobacillus) and silver nanoparticles as compared to metronidazole. A cross-sectional study was done in which stool samples were collected from patients suffering from IBS.The stool samples were examined microscopically to detect B. hominis and any co-parasitism. All positive stool samples were cultured on Modified Jones' media. BALB/C mice were infected by isolated Blastocystis. The effect of probiotics and silver nanoparticles on blastocystosis was tested in experimentally infected mice. Cysts' mean count in stool of infected mice markedly decreased; with a decrease in serum levels of nitric oxide and glutathione antioxidants compared to drug control one. There was intestinal villi improvement of infected groups treated with probiotics and silver nanoparticles,with mild inflammation and decrease of Blastocystis at the intestinal surface as compared to the infected group metronidazole treated.

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