Immunohistochemical Study of Caspase 3 and Cyclin D1 In Bilharzial Bladder Cancer and Their Significance

12 Abstract: Tumor growth is the result of cell excessive proliferation and lack of apoptosis. Apoptosis has been considered to be closely associated with Caspase-3. Cell cycle proteins are important markers in predicting tumor behavior in urothelial carcinoma of the bladder over expression of the D1 cyclins allow uncontrolled tumour cell proliferation. This study was designed to investigate the expression of Caspase-3 and cyclin D1 to evaluate their role on the tumorgenesis and progression in bladder cancer (associated with bilharziasis or not associated).The immunohistochemistry (SP method) was used to determine the expression of caspase-3 and cyclin D1 in 45 cases of Bladder cancer (30 TCC and 15 SCC), 10 control and 10 bilharzial cystitis. Caspase 3 was present as faint intracytoplasmic brownish staining of the urothelial cells in 90% of control cases, 80% in benign conditions and 48% of bladder cancer cases. The protein expression level of Caspase-3 was 48% of Bladder cancer cases (24/45) which was significantly lower than that in normal bladder samples (P< 0.001). Caspase-3 expression level was decreases in SCC compared to TCC cases P< 0.05, also caspase 3 showed decrease expression in bilharzial compared to non bilharzial cancer cases P< 0.01. Caspase-3 expression level was correlated with the grades of TCC (P< 0.01), and with clinical stages (P< 0.05). The overall expression of cyclin-D in malignant conditions was 50.6%. Cyclin-D was not expressed in control cases and was expressed in only 10% in bilharzial cystitis. Expression of cyclin-D was more significant in low-grade and superficial tumors than in high-grade and invasive tumors. In conclusion, Caspase 3 and cyclin-D expression in bladder tissue may be of help in detection of bladder cancer and can be used more effectively in combination with other tumor markers.