الفهرس 
AbstractOnly 14 pages are availabe for public view
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Abstract
In most studies, the role of adjuvant chemotherapy in locally advanced urothelial carcinoma of the bladder is still a matter of debate. P-glycoprotein (Pgp), which acts as an energy-dependent cellular efflux pump was shown to reduce intracellular concentrations of a variety of cytotoxic drugs, Thus far, only a few chemotherapy response modifiers have been assessed in small retrospective studies of bladder cancer, which failed to produce unequivocal results. All studies which estimated P-gp in bladder cancer worked on TCC which is more common in Europe and USA, and this is the first study which compares between P-gp expression in TCC, SCC and Adenocarcinoma. Conventional analysis of frozen tissue sections using H&E staining enables diagnosis within 20 minutes at most institutions, but the sensitivity of this method for detecting micrometastases is comparatively low. By contrast, the sensitivity of IHC analysis is sufficient to detect micrometastasis, but the standard IHC procedure commonly requires 2–4 hours to complete. Several investigators proposed rapid methods that enable the IHC procedure to be accomplished within only 12 to 30 minutes. This study included 133 patients for whom radical cystectomy was carried out, 98 of them were between 2003 and 2004 and 35 were between 2009 and 2010 ( for obtaining frozen tissue). The mean age was 55.14 ± 8.18 years and the male to female ratio was 2.8 : 1. The study included 60 patients with Transitional Cell Carcinoma type, 44 patients with Squamous Cell Carcinoma type, 29 patients with Bladder Adenocarcinoma type.P-gp expression was immunohistochemically estimated using two techniques, one was rapid technique using frozen acetone fixed sections, and the other was the standard technique using paraffin tissue.P-gp monoclonal antibody was used for staining.Univariate and multivariate statistical analysis were used. The 5-year survival rate of the whole study group was 39.8%. Tumour grade, tumour stage, age, P-gp expression, type and lymph node status had significant impact on survival of patients using univariate analysis. The lymph node status only sustained its significant impact on survival in multivariate analysis. P-gp expression was correlated significantly with histologic type and grade. Bladder Adenocarcinoma type had a higher mean than other types. In summary, the results of our study indicated that the type and grade of tumour could play an important role in the assessment of therapy used for bladder cancer patients, lymph node status could provide more objective tool for better judgment on the patient survival and might help in choice of the more convenient therapy for the individual patient and using of a rapid IHC technique could provide a rapid tool for diagnosis.