Changes in histopathological phenotypes of Schistosomaassociated urinary bladder cancer in Sohag, Egypt

Abstract

Background: Squamous cell carcinoma is the most common type in Egyptian bilharzial bladder. However,there is a proven changing pattern of Schistosoma-associated bladder cancer (SA-BC) that needs to beinvestigated.Objective: To assess the patterns (age, incidence, and histopathological types) of SA-BC in Sohag, Egypt.Material and Methods: This descriptive retrospective study included 152 patients histologicallyconfirmed urinary BC diagnosed at the Pathology Department of Sohag University Hospital during 4 years,from January 2019 to December 2022. Data including age, sex, residence, and histopathological type wereretrieved from the records of Pathology Department.Results: Patients’ age ranged from 35-79 years with a mean of 61.2±9.1 years, and male to female ratiowas 4.6:1. Transitional cell carcinoma (TCC) was the most common histological type (80.9%), followed bysquamous cell carcinoma (SCC) (12.5%), and TCC with squamous differentiation (6.6%). Schistosoma eggswere histologically confirmed in 39.5% of cancer cases; 76.7% were TCC, 21.7% were SCC and only 1.6%was TCC with squamous differentiation. All SA-BC were male with mean age of 59.8±7.5. At the time ofdiagnosis, 96.7% of SA-BC cases were bladder muscle invasive and 91.7% were of high-grade nature notsignificantly different from cases with non-Schistosome associated BC (NSA-BC).Conclusion: The histopathological patterns of SA-BC have changed in Egypt over the past decade andmost cases were associated with TCC.