الفهرس 
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Abstract
Summary
Urinary bladder carcinoma represents the ninth most common cause of cancer worldwide and the thirteenth most common cause of cancer deaths. Over 90% of cases of urinary bladder carcinoma are urothelial carcinomas.
The exact etiology of bladder cancer is still unknown. Several risk factors have been reported as being involved in its pathogenesis such as cigarette smoking, synthetic nitrogen fertilizers, organophosphate based pesticides, pelvic irradiation, cyclophosphamide, chronic cystitis, schistosomiasis, human papilloma virus, genetic predisposition and some occupations such as working in dye industry .The relative importance of such risk factors in the pathogenesis of the disease differs in different populations.
CD10 also known as neutral endopeptidase is a zinc dependent cell surface metallopeptidase, expressed in the epithelial cells of the kidney, breast lung, intestine and prostate. CD10 contains a large extracellular domain that enzymatically cleaves a variety of neuropeptides including bombesin, substance P and endothelin 1. CD10 has been shown to play a role in migration, survival and apoptosis of cancer cells. However, the exact physiological significance remains largely unknown. CD10 is thought to affect invasion and metastatic potential of tumor cells by altering the cellular microenvironment. Changes in CD10 activity have been demonstrated to have different effects in different tumor types.
The present study was conducted on 40 cases of previously diagnosed urothelial bladder carcinoma obtained from the Pathology Department, Faculty of Medicine, Cairo University, during the period from January 2014 to December 2015. The paraffin blocks were recut at 5 microns thickness and stained with Hematoxylin & Eosin and CD10 monoclonal antibody.
The studied cases were predominantly males (80%). The age incidence ranged from 40 years to 87 years with a mean age of 62.65 years and peak incidence among the age group above 60 years old. Twenty two cases (55%) of the studied tumors were > 3 cm in diameter while 45% of the cases were ≤ 3 cm.
Regarding tumor grade, the majority of the studied tumors (85%) were high grade while 15% were low grade. In this study, conventional invasive urothelial type was the most frequent histological type representing (32.5%) of the total studied cases followed by squamous differentiation (25%), glandular differentiation (7.5%), micropapillary and clear cell differentiation (2.5%) each, while all non muscle invasive tumors (30%) were papillary variants.
According to the depth of invasion (T stage), 70% of the studied cases showed muscle invasion arranged as following:
pT3 represented 30% of the cases, pT2 (25%) and while each of pTa, pT1 and pT4 represented 15% of the total studied cases. Lymph node metastases were detected in seventeen cases (60.7%). Moreover, schistosomal ova were detected in 50% of studied cases. Only three cases (7.5%) showed vascular invasion in the examined specimens. Also, there was perineural invasion in 17.5% of the studied cases.
In this study, 80% of the studied cases showed positive CD10 expression. A statistically significant correlation was detected between CD10 expression and tumor grade (P value= 0.002) and pathological T stage (P value= 0.002).
The correlation between CD10 expression and other clinicopathological parameters such as age, sex, tumour size, lymph node status, bilharzial infestation and perineural invasion was statistically insignificant.