EVALUATION OF THE PROGNOSTIC VALUE OF THE EXPRESSION OF EPIDERMAL GROWTH FACTOR RECEPTORS IN BLADDER CANCER

Objectives To evaluate the role and prognostic value of the expression of epidermal growth factor receptors (EGFR) in serum and urine for the detection of human bladder cancer. Patients and Methods The study comprised 30 patients with newly diagnosed transitional cell carcinoma of the bladder and 10 normal volunteers. The patients' age ranged from 42 to 76 years. The serum and urinary EGFR levels were evaluated using the ELISA technique. An indirect haemoagglutination (IHA) test was used for the detection of bilharzial antibodies. Cystoscopy, tumor resection and bimanual examination under anaesthesia were carried out for every patient. The patients were divided into 4 groups: Group A: 10 healthy individuals serving as a control group, Group B: 7 patients with grade I bladder cancer, Group C: 10 patients with grade II bladder cancer and Group D: 13 patients with grade III bladder cancer. Results Bilharziasis was recorded in 33 patients, 6 of them were in the control group. A comparison between the bilharzial and non-bilharzial patients did not reveal any significant difference in the serum EGFR expression (46.47 ± 32.23 and 36 ± 38.22 fmol/ml, respectively) nor in the urinary EGFR expression (45.42 ± 29.78 and 41 ± 31.16 fmol/ml, respectively). None of the patients with grade I bladder cancer was found to have stage T3 and T4 cancer, while all the patient with grade II and grade III cancer had invasive cancer (> Ta). The mean values of urinary and serum levels of EGFR in the control group were 12.37 ± 7.21 and 11.9 ± 8.17 fmol/ml, respectively, while the mean values of urinary and serum levels of EGFR in the cancer patients were 46.47 ± 32.23 fmol/ml and 45.4 ± 29.78 fmol/ml, respectively, which represents a significant increase in the serum and urinary EGFR in the cancer patients as compared to the control goup. In addition, a stepwise increase in the serum and urinary EGFR was noted with the cancer grade increasing from grade I to III. The best cut-off values for serum and urinary EGFR were 22 fmol/ml and 25 fmol/ml, respectively. The best cut-off point for the serum EGFR level had a sensitivity of 83.3%, a specificity of 90% and an accuracy of 85%, while the best cut-off point for the urinary EGFR level had a sensitivity of 80%, a specificity of 90% and an accuracy of 82.5%. Conclusion Resultsof the present study suggest that high levels of EGFR in the serum and urine of patients with bladder cancer are related to various malignant histological features (tumor grade) and invasiveness of bladder cancer. In the future, the evaluation of urinary and serum EGFR might help in the prediction of recurrence rate, response to systemic treatment and in the screening of bladder tumors. African Journal of Urology Vol. 7 No. 1 (Jan 2001): pp 20-26 Key Wordsbladder cancer, epidermal growth factor receptors, tumors marker

Immunomodulatory effect of propofol versus sevoflurane in patients undergoing thoracic surgery using one lung ventilation technique

Introduction: One lung ventilation (OLV) has become a standard procedure for many interventions in thoracic surgery with a need for deflation of the lung to facilitate the surgical procedure. Mechanical ventilation can induce a proinflammatory reaction in the non-deflated ventilated lung. However only limited data exist on inflammatory alterations in the temporarily deflated, non-ventilated lung in patients undergoing thoracic surgery. Aim of the work: The aim of this work is to compare between the effects of propofol and sevoflurane as regards: the systemic inflammatory response, the pulmonary inflammatory response, C-reactive protein, leucocyte count, and recovery status, in patients undergoing thoracic surgery using OLV technique. Patients and methods: This study include 40 adult patients, who were randomly classified into two groups: group (I) 20 patients received total intravenous anesthesia with propofol. Group (II) 20 patients received inhalational anesthesia with sevoflurane. Every patient was subjected to a careful pre-anaesthetic assessment, anaesthesia, bronchoalveolar lavage (BAL) analysis for human inflammatory mediators (IL-6 and TNF-α), serum analysis for systemic inflammatory mediators (IL-6 and TNF-α) (Both were measured before OLV and 15 min after OLV ended and resumption of two lung ventilation (TLV) at the end of surgery, and C-reactive protein and leukocyte count in blood (before OLV, 15 min after OLV ended and resumption of (TLV) at the end of surgery and on the 2nd postoperative day). Results: According to IL-6 and TNF-α, there was no statistically significant difference between the two groups before OLV, however they were significantly increased in both groups in serum and BAL after OLV in relation to before OLV with significant increase in group I relative to group II. A significant correlation was present between increased level of IL-6 and TNF-α in BAL and their levels in serum after OLV in the group II but this correlation was not present in the group I. Also no significant correlation between duration of OLV and inflammatory mediators (IL-6 and TNF-α) in serum and BAL in both groups. As regarding to CRP, there was no statistically significant difference between the two groups before OLV. After OLV and on the 2nd postoperative day the level of CRP increased significantly in both groups with significant increase in group I relative group II. According to WBC count there was no statistically significant difference between the two groups as regards the level of WBC before OLV. After OLV the level of WBC increased significantly in group I only. On the 2nd postoperative day the level of WBC increased significantly in both groups with significant increase in group I relative to group II. Also no significant correlation between duration of OLV with the increased levels of CRP and WBC count in both groups. Conclusion: Propofol increased pulmonary and systemic cytokine release more than sevoflurane during OLV. Propofol has increased CRP level and WBC count more than sevoflurane during OLV

Alterations in proteins and amino acids of the Nile cyanobacteria Pseudanabaena limnetica and Anabaena wisconsinense in response to industrial wastewater pollution

The effect of industrial wastewater on the Nile cyanobacteria Pseudanabaena limnetica and Anabaena wisconsinense was investigated. The data showed that P. limnetica was more sensitive to pollution than A. wisconsinense. The treatments with different levels of wastewater exerted pronounced reductions in protein and amino acids content. SDS-PAGE analysis revealed that the cyanobacteria grown in the industrial wastewater showed induction in the synthesis of certain polypeptides and repression of others. The treatments of P. limnetica with wastewater stimulated the appearance of six protein bands with molecular masses of 28, 30, 31, 32, 58 and 97 kDa. The same treatments caused the disappearance of 20, 38 and 56 kDa. The structural protein pattern of the treated A. wisconsinense showed appearance of 16, 30, 170 and 230 kDa and disappearance of 56 kDa. The treatment of the two investigated cyanobacteria with different levels of wastewater stimulated the biosyntheses of different amino acids and inhibited others