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Abstract In this study, evaluation of tumour angiogenesis -which is one of the recently introduced prognostic factors in many tumours including the bladder tumour -was carried out in a group of patients with schistosoma-associated bladder tumour for the first time as far as we knew. ~ This retrospective study included 337 patients for whom radical cystectomy and urinary diversion were carried out between 1985 and 1995. The mean age was 48.2 :t 8.6 years and the male to female ratio was 73.3 : 26.7. The study included 160 patients with squamous cell carcinoma, 122 with transitional cell carcinoma, and 55 with adenocarcinoma. Patients were stratified according to grade (WHO, 1973), stage (UICC, 1997), lymph node status, DNA ploidy and angiogenesis. Angiogenesis was evaluated by measuring the mean microvessel density (MVD). Vessels were immunohistochemically stained using antibody to platelet endothelial cell adhesion molecule CD3l.Microvessels were counted in active areas of angiogenesis (hot spots) under magnification of X250 and’ th~ mean of 3 counts (MVD) was used for univariate and multivariate statistical analysis. The 5-year survival rate of the whole study group was 51.8%. In squamous cell carcinoma, tumour grade, stage, lymph node status, DNA ploidy, and MVD had a significant impact on survival of patients in univariate analysis. All except the grade sustained their significant impact on survival in multivariate analysis. MVD was correlated significantly with patient sex and tumour grade only: In adenocarcinoma, the presence of lymph node metastasis and high vascular density were significantly associated with a poor prognosis. This significance was maintained on multivariate analysis. There was no significant relationship betwe~n angiogenesis and the different clinicopathological factors apart from the grade (P = 0.03). In transitional cell carcinoma, tumour grade, stage, and lymph node status, were significant prognostic factors in univariate analysis, but only the stage and lymph node status sustained their significance in multivariate analysis. Tumour angiogenesis had no significant effect on patient survival. It had a significant relationship with tumour stage only, where superficial tumours were more vascular than invasive tumours and organ confined tumours were more vascular than non-organ confined tumours. |