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Abstract
Bladder cancer ranks fourth in incidence among all cancers in males and ninth in females worldwide. Males have fourfold excess of bladder cancer compared to females. Despite the marked decrease in prevalence of endemic bilharziasis over the last two decades, bladder cancer is still the most prevalent cancer in Egypt.
The gold standard for diagnosing bladder cancer is cystoscopy. It provides direct visualization and localization of the tumor and a means for biopsying abnormal areas. It also
permits initial assessment of tumor grade and stage. However, cystoscopy can fail to detect CIS. It may have inconclusive results particularly in case of cystitis. The procedure is invasive, relatively expensive, often a source of patient anxiety, in addition to a 10% possibility of causing urinary tract infection.
Another adjuvant means for diagnosis of bladder cancer is urine cytology. However,it has many limitations, namely that welldifferentiated tumors have normally appearing cells, are tightly
cohesive and not readily shed in urine. This makes its overall sensitivity among different grades of differentiation only 20% to 40%.
These concerns have driven the search for other noninvasive, less expensive and more reliable markers for this
disease. Among these is survivin, a 16.5kDa cytoplasmic protein with chromosomal location at 17q25. It is a member of the antiapoptotic proteins which are capable of regulating both
cell proliferation and apoptotic cell death, so contributing to carcinogenesis and cancer progression.
In this regard, our study aimed at assessment of the diagnostic sensitivity and specificity of PCR-based detection of urinary survivin in bladder cancer with evaluation of its
prognostic significance through its possible association with tumor histopathological stages, grades and types.