الفهرس 
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Abstract
Dissertation Abstract : Back ground : Erectile dysfunction (ED) is a major world-wide problem, it is associated with many urological diseases including benign prostatic hyperplasia(BPH) (Gonzalgo et al., 2003). Of patients developed histologic BPH, 30-50% will develop bothering lower urinary tract symptoms (LUTS). Medical treatment of LUTS/BPH can adversely affect erectile and ejaculatory functions (Narayan and Lepor, 2001). A recent study by Gur et al (Gur et al., 2016) investigated the effect of mirabegron on HCC in vitro and showed marked relaxation of HCC by activating B3-adrenoceptors independently of nitric oxide (NO) pathway. Aim of the work: To predict WT recurrence and mortality by using p53, Ki67 and cyclin A immunohistochemistry (IHC). Patients: In this nonconcurrent cohort study, 75 cases were enrolled. Patients’ archived data including age at presentation, gender, history, clinical examination and radiological investigations were retrieved. Methods : Formalin-fixed paraffin-embedded specimens, obtained from the previously preserved blocks at the pathology laboratory stained with Hematoxylin and Eosin to be used for tumor staging and grading. Moreover, 3 to 5 μm sections were taken on positively charged slides for IHC with p53, Ki67 and cyclin A. P53 and cyclin A staining were scored as 0 (no nuclear staining), 1 (<10% nuclear staining), 2 (10-50% nuclear staining) and 3 (>50% nuclear staining) (Yuichi et al, 2000). Ki67 proliferation index (PI) was graded as low (L), borderline (BL) and high (H)(Krishna et al, 2016). For statistical purposes, p53 and cyclin A grades 2 and 3 plus H grade Ki67 were reported as positive (+). Results and conclusion: Positive cyclin A staining was associated with higher relapse and mortality rates (P= 0.01 and 0.02, respectively). Moreover, residual tumour was associated with increased cancer-specific mortality (CSM) (P=0.02). P53 was highly expressed in cases with UFH (P=0.04), but not with advanced stages (P=0.95). Ki67 expression did not differ neither between low and high stages (P=0.75), nor favourable and UFH (P=0.22). Cyclin A did not show overexpression with higher stages (P=0.46) or UFH (P=0.73). In light of the above, cyclin A overexpression in WT can be used as a predictor for poor outcomes. Recommendations: Cyclin A overexpression in WT can be used as a predictor for poor outcomes.