الفهرس 
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Abstract
This study aimed to evaluate the immunohistochemical expression of VDR in urinary bladder carcinoma in a group of Egyptian patients and to study their relations with clinical and pathological factors.
The material of this study consists of 74 specimens; 34 obtained by TURT and 40 by radical cystectomies, collected from the pathology lab of Beni-Suef university hospital in the form of formalin fixed paraffin embedded tissue blocks. Demographic and pathological data were obtained from patients’ reports.
The age incidence ranged from 35 to 77 years with an overall mean age 62.65 year. There was a significant male predominance with male to female ratio 2.5:1. Most tumor size was ≥ 3cm. The urothelial carcinoma was the most frequent histological type representing 73% while 23% of cases were non urothelial. The majority of urothelial cases were conventional type (31.5%) while keratinizing SCC was the most common histology of non urothelial ones (45%). Most of tumor tissues were high grade. Muscle invasion was noted in 54.1% of cases. Tumor stage T3 was the most frequent stage in the studied urothelial and non urothelial cases (22.2% and 55% respectively). Only 20 cases showed positive lymph node metastasis. Moreover, Bilharzial infestation was noted in 64.9% of cases. The associated chronic inflammation was in 85.1% of cases. In addition, 31 cases showed tumor necrosis. Lymphovascular and perineural invasions were noted in 23 % and 27% of cases respectively.
Our study revealed that the VDR was expressed in both normal urothelium and all studied tumor tissues. We assessed each case separately for nuclear and cytoplasmic patterns of VDR` expression.
In urothelial tumors, VDR expression significantly related to muscle invasion, pathological stage, nodal metastasis and tumor necrosis. Also, nuclear VDR was significantly related to muscle invasion and pathological stage. However, no significant relation was found between other clinicopathological variables and VDR expression. Also cytoplasmic VDR was not related to muscle invasion, tumor pathological stage or lymph nodal metastasis.
In non urothelial tumors, there was a strong association between nuclear pattern of VDR expression with tumor grade, muscle invasion, tumor stage and associated inflammation. However, no significant relation was found between all clinicopathological variables and VDR expression by tumor cells. Also, cytoplasmic VDR expression was not related to tumor grade, muscle invasion, stage or nodal metastasis.
Finally, we have assessed the nuclear pattern of VDR expression among urothelial and non urothelial tumors with statistically significant relation. Also moderate positive linear correlation between the nuclear VDR and tumor grade of all studied cases was found.
However, no significant relation was detected among the urothelial tumors or non urothelial ones and cytoplasmic VDR, although a significant negative linear correlation with tumor grade and stage was found.
We have finally concluded that VDR may have a role in prevention of cancer development and progression in urinary bladder and could be a promising therapeutic target. Additionally, our findings regarding nuclear pattern of VDR expression could be a remarkable prognostic marker in urinary bladder carcinoma patients.