Immunohistochemical Expression of Androgen and Estrogen Receptors and their Prognostic Significance in Urothelial Carcinoma of the Urinary Bladder

Abstract
Background: Bladder cancer is the most common malig-nancy affecting the urinary tract. It is the fourth most common cancer in men and the ninth most common in women world-wide. It is at least three times more common in males than females suggesting the role of sex hormones in initiation and progression of bladder cancer. The purpose of this study is to detect the immunohistochemical expression of (AR) and (ERb) in urothelial carcinoma and correlate their expression with the known prognostic parameters of urothelial carcinoma to illustrate their prognostic role.
Material and Methods: Seventy cases of urothelial carci-noma of the urinary bladder in the form of radical cystectomy (15 specimens) and Transurethral Resection of the Tumour (TURT) (55 specimens) were collected retrospectively. They were stained by H & E, AR and ERb  for immunohistochemical study. The relationship between their expression and the available clinicopathological features were evaluated.
Results: AR/ERb  was positive in (62.9%/52.9% respec-tively) of the studied cases. Significantly lower expression of AR/higher expression of ERb  were found in high-grade tumours (52.4%/66.7% respectively) (p-value=0.025, 0.005 respectively) and in muscle invasive tumours (48.4%/71% respectively) (p-value=0.026, 0.007 respectively).
Conclusions: AR and ERb  expression were significantly correlated with the tumour grade and degree of invasion suggesting the suitability of AR and ERb  as prognostic markers of urothelial carcinoma. High AR expression was associated with favorable prognosis of urothelial carcinoma in contrast to high ERb  expression which was associated with bad prog-nosis of urothelial carcinoma.