Abstract

ABSTRACT:
OBJECTIVE:
To study the frequency of schistosomiasis in pathologic urinary bladder specimens and the contribution of transitional cell and squamous cell types to the schistosoma – associated and non schistosoma – associated bladder cancer among Iraqi patients.
METHODS:
This is a retrospective study in which 1092 pathologic records of 933 patients, who underwent urinary bladder biopsies from bladder tumors or suspicious lesions discovered incidentally during endoscopic evaluation and those who ultimately had radical cystectomy and urinary diversion for invasive bladder cancer, were reviewed in Surgical Specialties Hospital, Baghdad, Iraq between June 2000 and June 2007.
RESULTS:
In this study 933 patients aged 2-100 years with a mean age of 56.87±14.3 years. Pathologic review showed schistosomiasis in 81 (8.68%) patients of whom schistosoma associated bladder cancer was reported in 49 (60.5%) patients and schistosomiasis with no pathologic evidence of malignancy in 32 (39.5%) patients. The cell type of schistosoma associated bladder cancer was transitional cell carcinoma (TCC) in 26 (53%), squamous cell carcinoma (SCC) in 19 (38.7%), adenocarcinoma in 1 (2%), and undifferentiated in 3 (6.12%) patients. Out of 852 patients with no pathologic evidence of schistosomiasis, 563 were reported to have non schistosoma associated bladder cancer. The cancer cell type was TCC in 491 (87.21%), SCC in 45 (7.99%), adenocarcinoma in 15 (2.66%), undifferentiated in 11 (1.95%) and sarcoma in 1 (0.18%) patients.
CONCLUSION:
Schistosoma associated bladder cancer is still a problem in Iraq as well as other endemic countries. Although the major histological cell type of such cancer in Iraq was SCC, there is a trend for increasing frequency of TCC among patients infected with schistosomiasis.